| NPI | 1245666866 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH BURNETT Owner 571-223-7686 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center Physical Therapy (Licence: VA 2305006615) |
| Enumeration Date | 2013-09-16 |
| Last Update Date | 2013-09-16 |