| NPI | 1265868814 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYLER WHITESIDE President 703-980-5570 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: NC 11905) |
| Enumeration Date | 2013-09-15 |
| Last Update Date | 2025-08-13 |