Healthcare Provider Details

I. General information

NPI: 1023436631
Provider Name (Legal Business Name): ANNA VANALSTYNE DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2014
Last Update Date: 05/15/2023
Certification Date: 05/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3259 CATLIN AVENUE NAVAL HEALTH CLINIC QUANTICO
QUANTICO VA
22134-6050
US

IV. Provider business mailing address

3259 CATLIN AVENUE NAVAL HEALTH CLINIC QUANTICO
QUANTICO VA
22134
US

V. Phone/Fax

Practice location:
  • Phone: 703-784-1793
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2013028745
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License NumberPT301174
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: