| NPI | 1104068717 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGIE SAGLE Physician Administrator 571-330-3165 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305204844) |
| Enumeration Date | 2009-03-27 |
| Last Update Date | 2009-06-05 |