| NPI | 1093199275 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA HOLDAWAY Practice Manager 571-719-3563 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305207830) |
| Enumeration Date | 2015-07-16 |
| Last Update Date | 2023-12-06 |