Healthcare Provider Details

I. General information

NPI: 1275854960
Provider Name (Legal Business Name): MAKING PROGRESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2010
Last Update Date: 06/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5249 DUKE ST #203
ALEXANDRIA VA
22304-2926
US

IV. Provider business mailing address

5249 DUKE ST #203
ALEXANDRIA VA
22304-2926
US

V. Phone/Fax

Practice location:
  • Phone: 703-370-2970
  • Fax: 703-370-7209
Mailing address:
  • Phone: 703-370-2970
  • Fax: 703-370-7209

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License Number2305205494
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License Number2305000926
License Number StateVA

VIII. Authorized Official

Name: SUSAN RYERSON
Title or Position: PHYSICAL THERAPIST
Credential: PT
Phone: 703-370-2970