Healthcare Provider Details

I. General information

NPI: 1689213159
Provider Name (Legal Business Name): FAMILY PHYSICAL THERAPY AND WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2020
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7501 LITTLE RIVER TPKE STE 306
ANNANDALE VA
22003-2923
US

IV. Provider business mailing address

10706 ROSEHAVEN ST
FAIRFAX VA
22030-2827
US

V. Phone/Fax

Practice location:
  • Phone: 703-261-6005
  • Fax: 571-554-8002
Mailing address:
  • Phone: 202-460-8571
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: PARISA PAZOKI
Title or Position: PHYSICAL THERAPIST
Credential: PT, DPT
Phone: 202-460-8571