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General NPI Number Information
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NPI Number | 1447615661
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Entity Type | Organization
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Legal Business Name | PEOPLE TRUST PHYSICAL THERAPY, P.C.
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Dates
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Enumeration Date | 12/15/2015
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Last Update Date | 12/15/2015
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Provider Practice Location Address
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Address Line | 6860 COMMERCIAL DR SUIT #C
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City | SPRINGFIELD
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State | VA
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Zip | 22151-4201
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Country | US
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Telephone | 703-626-1465
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Fax |
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Provider Business Mailing Address
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Address Line | 3102 MEREWORTH CT
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City | OAKTON
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State | VA
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Zip | 22124-1758
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Country | US
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Telephone | 703-626-1465
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. SUNGNYU S. LEE
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Credential | P.T
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Telephone | 703-626-1465
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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 | 2305203083
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License Number State | VA
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