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General NPI Number Information
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NPI Number | 1134388903
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Entity Type | Organization
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Legal Business Name | BODY MECHANICS PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 06/05/2008
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Last Update Date | 06/05/2008
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Provider Practice Location Address
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Address Line | 102 DRY MILL RD SW SUITE 103
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City | LEESBURG
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State | VA
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Zip | 20175-2635
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Country | US
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Telephone | 703-737-3697
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Fax |
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Provider Business Mailing Address
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Address Line | 102 DRY MILL RD SUITE 103
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City | LEESBURG
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State | VA
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Zip | 20175
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Country | US
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Telephone | 703-737-3697
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. KATHARINE MARIE AYRES
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Credential | PT
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Telephone | 703-737-3697
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 2305831290
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License Number State | VA
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