Healthcare Provider Details

I. General information

NPI: 1447862693
Provider Name (Legal Business Name): DEVYN L HARTMAN DPT, PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2020
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8140 ASHTON AVE STE 104
MANASSAS VA
20109-5699
US

IV. Provider business mailing address

12701 FAIR LAKES CIR STE 102
FAIRFAX VA
22033-4913
US

V. Phone/Fax

Practice location:
  • Phone: 703-257-3333
  • Fax: 703-257-0066
Mailing address:
  • Phone: 703-257-3333
  • Fax: 703-257-0066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305213816
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberP19827
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: