Healthcare Provider Details

I. General information

NPI: 1912931908
Provider Name (Legal Business Name): ANN MICHELLE KAST MSPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 09/15/2020
Certification Date: 09/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4201 WILSON BLVD # 110-220
ARLINGTON VA
22203-1859
US

IV. Provider business mailing address

8200 COLSTON PL
CHEVY CHASE MD
20815-3032
US

V. Phone/Fax

Practice location:
  • Phone: 703-527-1700
  • Fax: 703-527-1507
Mailing address:
  • Phone: 703-465-1876
  • Fax: 703-527-1507

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number2305203179
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: