| NPI | 1942791439 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BROADWIN B ADESEGUN Owner 703-826-3743 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305204402) |
| Enumeration Date | 2018-05-21 |
| Last Update Date | 2022-06-09 |