Healthcare Provider Details

I. General information

NPI: 1427713007
Provider Name (Legal Business Name): ADAM FRAZIER FLUGER OTR/L
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/08/2021
Last Update Date: 11/08/2021
Certification Date: 11/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7501 HERITAGE VILLAGE PLZ
GAINESVILLE VA
20155-3078
US

IV. Provider business mailing address

8938 ENGLEWOOD FARMS DR
MANASSAS VA
20112-5878
US

V. Phone/Fax

Practice location:
  • Phone: 571-248-6100
  • Fax:
Mailing address:
  • Phone: 571-480-2968
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number0119006960
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: