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General NPI Number Information
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NPI Number | 1568702371
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Entity Type | Organization
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Legal Business Name | NOVA PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 02/15/2013
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Last Update Date | 02/15/2013
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Provider Practice Location Address
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Address Line | 11154 BUNCHBERRY CT
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City | WALDORF
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State | MD
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Zip | 20601-2631
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Country | US
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Telephone | 301-266-0738
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Fax |
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Provider Business Mailing Address
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Address Line | 8191 STRAWBERRY LN SUITE # 6
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City | FALLS CHURCH
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State | VA
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Zip | 22042-1031
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Country | US
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Telephone | 301-266-0738
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ASIYA AFTAB
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Credential |
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Telephone | 301-266-0738
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 2305206276
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License Number State | VA
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