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NPI 1346835741

NPI 1346835741 : HAILEY D GILL PT, DPT : WOODBRIDGE, VA

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General NPI Number Information
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    NPI Number           |    1346835741
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    Entity Type          |    Individual 
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    Provider Name        |    HAILEY D GILL PT, DPT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    03/08/2021
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    Last Update Date     |    03/08/2021
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Provider Practice Location Address
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    Address Line         |    14524 POTOMAC MILLS RD 
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    City                 |    WOODBRIDGE
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    State                |    VA
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    Zip                  |    22192-6803
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    Country              |    US
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    Telephone            |    703-490-6726
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    16730 BLACKJACK OAK LN UNIT 403 
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    City                 |    WOODBRIDGE
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    State                |    VA
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    Zip                  |    22191-7532
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    Country              |    US
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    Telephone            |    314-732-5159
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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        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    
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    License Number State |    
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