| NPI | 1982125100 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GILES ALEXANDER JACKSON Manager 202-257-4854 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305004961) |
| Enumeration Date | 2017-06-28 |
| Last Update Date | 2017-06-28 |