Healthcare Provider Details

I. General information

NPI: 1154448553
Provider Name (Legal Business Name): STRAIT PHYSICAL THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 09/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2579 JOHN MILTON DR SUITE 120
HERNDON VA
20171-2563
US

IV. Provider business mailing address

2579 JOHN MILTON DR SUITE 120
HERNDON VA
20171-2563
US

V. Phone/Fax

Practice location:
  • Phone: 703-860-2346
  • Fax: 703-860-2348
Mailing address:
  • Phone: 703-860-2346
  • Fax: 703-860-2348

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State

VIII. Authorized Official

Name: DONNA R STRAIT
Title or Position: OWNER AND CHIEF PHYSICAL THERAPIST
Credential: MSPT, COMT
Phone: 703-860-2346