Healthcare Provider Details

I. General information

NPI: 1477479939
Provider Name (Legal Business Name): MOBILITY LAB
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2026
Last Update Date: 06/27/2026
Certification Date: 06/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 CONNECTICUT AVE NW STE 500
WASHINGTON DC
20036-5304
US

IV. Provider business mailing address

750 KENILWORTH TER NE APT 619
WASHINGTON DC
20019-1520
US

V. Phone/Fax

Practice location:
  • Phone: 202-734-1157
  • Fax:
Mailing address:
  • Phone: 202-734-1157
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0800X
TaxonomyRecovery Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. KEITH JAMIL HUGHES
Title or Position: MASSAGE THERAPIST
Credential: LMT
Phone: 202-734-1157