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General NPI Number Information
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NPI Number | 1316826860
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Entity Type | Individual
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Provider Name | ELLA GRACE ROBERTS PT
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Gender | Female
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Dates
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Enumeration Date | 08/28/2025
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Last Update Date | 08/28/2025
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Provider Practice Location Address
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Address Line | 11507 SUNSET HILLS RD
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City | RESTON
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State | VA
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Zip | 20190-4704
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Country | US
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Telephone | 301-978-4838
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Fax |
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Provider Business Mailing Address
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Address Line | 612 N KENMORE ST
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City | ARLINGTON
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State | VA
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Zip | 22201-2221
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Country | US
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Telephone | 303-945-9473
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Fax |
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 2305217090
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License Number State | VA
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