| NPI | 1336622257 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILL KAREN WAGNER Owner, Physical Therapist 703-606-6213 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: VA 0105005106) |
| Enumeration Date | 2018-09-07 |
| Last Update Date | 2018-09-07 |