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General NPI Number Information
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NPI Number | 1508539974
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Entity Type | Organization
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Legal Business Name | JOINT ACADEMY PHYSICAL THERAPY OF VA, P.C.
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Dates
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Enumeration Date | 07/30/2021
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Last Update Date | 06/14/2023
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Provider Practice Location Address
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Address Line | 1320 CENTRAL PARK BLVD STE 200
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City | FREDERICKSBURG
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State | VA
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Zip | 22401-4953
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Country | US
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Telephone | 847-732-6921
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3404
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City | MERRIFIELD
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State | VA
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Zip | 22116-3404
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | LANDON COOK
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Credential |
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Telephone | 707-536-5434
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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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