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General NPI Number Information
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NPI Number | 1386499440
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Entity Type | Organization
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Legal Business Name | MAZIN PHYSICAL THERAPY PLLC
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Dates
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Enumeration Date | 04/22/2024
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Last Update Date | 04/22/2024
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Provider Practice Location Address
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Address Line | 3345 DUKE ST
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City | ALEXANDRIA
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State | VA
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Zip | 22314-5219
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Country | US
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Telephone | 703-786-3352
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Fax | 703-740-1075
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Provider Business Mailing Address
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Address Line | 5131 BALLYCASTLE CIR
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City | ALEXANDRIA
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State | VA
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Zip | 22315-5566
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Country | US
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Telephone | 703-786-3352
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Fax | 703-740-1075
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Authorized Official
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Title or Position | OWNER
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Name | MAKENZIE MAZIN
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Credential | PT, DSCPT
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Telephone | 703-786-3352
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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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