Healthcare Provider Details

I. General information

NPI: 1841124245
Provider Name (Legal Business Name): MEIHANNAH Y KOLB DPT, PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6564 LOISDALE CT STE 500
SPRINGFIELD VA
22150-1823
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 703-822-0039
  • Fax: 703-822-0211
Mailing address:
  • Phone: 703-822-0039
  • Fax: 703-822-0211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305217818
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: