Healthcare Provider Details

I. General information

NPI: 1821603663
Provider Name (Legal Business Name): GREGORY HARTMAN, DPT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2020
Last Update Date: 09/09/2020
Certification Date: 09/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47327 ROCK FALLS TER
STERLING VA
20165-2433
US

IV. Provider business mailing address

47327 ROCK FALLS TER
STERLING VA
20165-2433
US

V. Phone/Fax

Practice location:
  • Phone: 315-380-7244
  • Fax:
Mailing address:
  • Phone: 315-380-7244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. GREGORY JOSEPH HARTMAN
Title or Position: PHYSICAL THERAPIST
Credential: DPT
Phone: 315-380-7244