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NPI Code Detail

MEDICARE: MEREDITH MCCREA PT, DPT, ATC

MEDICARE: MEREDITH MCCREA PT, DPT, ATC
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
12255A2300XAthletic Trainer2000021289VA
2225100000XPhysical Therapist2305213127VA

General Provider Information

NPI Number : 1720636566
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEREDITH MCCREA PT, DPT, ATC
Provider Business Mailing Address
First Line : 3709 S GEORGE MASON DR APT 504E
Second Line :
City : FALLS CHURCH
State : VA
Zip : 22041-4751
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7410 SPRING VILLAGE DR
Second Line :
City : SPRINGFIELD
State : VA
Zip : 22150-4485
Country : US
Telephone Number : 703-923-4684
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/26/2019
Last Update Date : 12/13/2023

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