| NPI | 1750792404 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANA JILL WALLACE Owner 703-544-7171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225XH1200X Occupational Therapist, Hand (Licence: VA 0119005354) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: VA 0119005354) |
| Enumeration Date | 2014-05-15 |
| Last Update Date | 2020-12-09 |