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General NPI Number Information
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NPI Number | 1619006947
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Entity Type | Organization
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Legal Business Name | ITR PHYSICAL THERAPY. INC
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Dates
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Enumeration Date | 03/04/2007
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Last Update Date | 07/23/2024
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Provider Practice Location Address
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Address Line | 1313 DOLLEY MADISON BLVD STE 405
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City | MC LEAN
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State | VA
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Zip | 22101-3953
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Country | US
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Telephone | 301-770-7060
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Fax | 703-991-5369
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Provider Business Mailing Address
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Address Line | 2211 WAKEROBIN LN
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City | RESTON
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State | VA
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Zip | 20191-4105
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Country | US
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Telephone | 703-855-0281
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Fax | 703-991-5369
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Authorized Official
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Title or Position | PRESIDENT AND DIRECTOR
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Name | JENNIFER L CHU
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Credential | PT
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Telephone | 301-770-7060
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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 | 18949
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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