MEDICARE: GRACE KLUSTY DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	2305217803	VA

General Provider Information

NPI Number	:	1588597041
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GRACE KLUSTY DPT

Provider Business Mailing Address
First Line	:	1600 S JOYCE ST APT 1121
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22202-5124
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1220 N FILLMORE ST
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22201-6503
Country	:	US
Telephone Number	:	833-493-4325
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/04/2026
Last Update Date	:	06/04/2026

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Directions to “ GRACE KLUSTY DPT” Practice Location

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