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General NPI Number Information
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NPI Number | 1508977083
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Entity Type | Organization
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Legal Business Name | MT. VERNON ORTHOPEDIC CENTER AND SPORTS MEDICINE
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 8101 HINSON FARM RD SUITE 312
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City | ALEXANDRIA
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State | VA
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Zip | 22306-3403
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Country | US
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Telephone | 703-765-4321
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Fax |
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Provider Business Mailing Address
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Address Line | 8101 HINSON FARM RD SUITE 312
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City | ALEXANDRIA
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State | VA
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Zip | 22306-3403
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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 | BILLING MANAGER
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Name | DEBBIE. LEIGH BIRD
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Credential |
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Telephone | 703-765-4321
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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 | VA
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