Healthcare Provider Details

I. General information

NPI: 1013825348
Provider Name (Legal Business Name): WILFONG MOBILE PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

616 ELLIOT DR
PURCELLVILLE VA
20132-3389
US

IV. Provider business mailing address

PO BOX 8
PURCELLVILLE VA
20134-0008
US

V. Phone/Fax

Practice location:
  • Phone: 540-212-9852
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE WILFONG
Title or Position: PHYSICAL THERAPIST
Credential:
Phone: 540-212-9852