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General NPI Number Information
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NPI Number | 1053616755
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Entity Type | Individual
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Provider Name | MARIA CATALINA LEMCKE PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 01/11/2011
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Last Update Date | 11/12/2015
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Provider Practice Location Address
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Address Line | 14535 JOHN MARSHALL HWY SUITE 203
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City | GAINESVILLE
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State | VA
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Zip | 20155-4023
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Country | US
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Telephone | 703-753-0974
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Fax | 703-753-9709
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Provider Business Mailing Address
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Address Line | 14535 JOHN MARSHALL HWY SUITE 203
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City | GAINESVILLE
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State | VA
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Zip | 20155-4023
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Country | US
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Telephone | 703-753-0974
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Fax | 703-753-9709
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2305206752
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License Number State | VA
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