Healthcare Provider Details

I. General information

NPI: 1780611046
Provider Name (Legal Business Name): SPORTS THERAPY AND REHABILITATION,INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2006
Last Update Date: 03/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1112 16TH STREET NW SUITE 200
WASHINGTON DC
20036
US

IV. Provider business mailing address

1112 16TH STREET NW SUITE 200
WASHINGTON DC
20036
US

V. Phone/Fax

Practice location:
  • Phone: 202-223-1737
  • Fax: 202-223-1738
Mailing address:
  • Phone: 202-223-1737
  • Fax: 202-223-1738

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MS. BELINDA DENISE THOMAS
Title or Position: OFFICE MANAGER
Credential:
Phone: 202-223-1737