Healthcare Provider Details
I. General information
NPI: 1881139079
Provider Name (Legal Business Name): DR. ALINA, LLC DBA FULL DISTANCE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/27/2016
Last Update Date: 02/03/2025
Certification Date: 02/03/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
130 S 20TH ST
PURCELLVILLE VA
20132-3301
US
IV. Provider business mailing address
PO BOX 378
HUDDLESTON VA
24104-0378
US
V. Phone/Fax
- Phone: 540-931-3037
- Fax: 571-363-2753
- Phone: 540-328-1983
- Fax: 571-363-2753
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225700000X |
| Taxonomy | Massage Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ALINA
D
DAWSON
Title or Position: OWNER AND PHYSICAL THERAPIST
Credential: DPT, PT
Phone: 540-227-6086