| NPI | 1922501485 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN A COFFEY Owner 540-871-3426 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305209634) |
| Enumeration Date | 2018-03-12 |
| Last Update Date | 2018-03-12 |