Healthcare Provider Details

I. General information

NPI: 1033089214
Provider Name (Legal Business Name): ZAU LAHTAW PT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/11/2025
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9010 LORTON STATION BLVD STE 270
LORTON VA
22079-4798
US

IV. Provider business mailing address

9010 LORTON STATION BLVD STE 270
LORTON VA
22079-4798
US

V. Phone/Fax

Practice location:
  • Phone: 540-898-6500
  • Fax: 540-834-0363
Mailing address:
  • Phone: 540-898-6500
  • Fax: 540-834-0363

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305217489
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: