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General NPI Number Information
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NPI Number | 1376374975
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Entity Type | Organization
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Legal Business Name | MICHELLE KONDRACKI OCONNOR PT
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Dates
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Enumeration Date | 08/13/2024
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Last Update Date | 09/09/2024
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Provider Practice Location Address
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Address Line | 4609 PINECREST OFFICE PARK DR STE B
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City | ALEXANDRIA
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State | VA
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Zip | 22312-1442
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Country | US
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Telephone | 703-718-6386
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Fax |
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Provider Business Mailing Address
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Address Line | 4400 17TH ST N
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City | ARLINGTON
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State | VA
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Zip | 22207-2308
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Country | US
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Telephone | 609-828-6104
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Fax |
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Authorized Official
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Title or Position | OWNER/ PHYSICAL THERAPIST
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Name | MICHELLE O'CONNOR
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Credential | MPT
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Telephone | 609-828-6104
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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