Healthcare Provider Details

I. General information

NPI: 1376478263
Provider Name (Legal Business Name): PURSUIT REHAB SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1125 WOODSTOCK RD
KING GEORGE VA
22485-6004
US

IV. Provider business mailing address

1125 WOODSTOCK RD
KING GEORGE VA
22485-6004
US

V. Phone/Fax

Practice location:
  • Phone: 814-617-0274
  • Fax:
Mailing address:
  • Phone:
  • 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: MAKENZIE PERSUN
Title or Position: PHYSICAL THERAPIST
Credential: PT, DPT, CWT
Phone: 814-617-0274