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General NPI Number Information
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NPI Number | 1619218690
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Entity Type | Organization
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Legal Business Name | PURE SPORTS PHYSICAL THERAPY
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Dates
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Enumeration Date | 03/15/2013
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Last Update Date | 02/26/2024
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Provider Practice Location Address
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Address Line | 1218 9TH ST NW
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City | WASHINGTON
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State | DC
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Zip | 20001-4202
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Country | US
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Telephone | 202-656-8184
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Fax | 202-600-7627
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Provider Business Mailing Address
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Address Line | 1218 9TH ST NW
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City | WASHINGTON
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State | DC
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Zip | 20001-4202
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Country | US
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Telephone | 202-656-8184
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Fax | 202-600-7627
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Authorized Official
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Title or Position | CEO/OWNER
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Name | PURVI SHETH
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Credential | MSPT
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Telephone | 202-656-8184
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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 | PT870491
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License Number State | DC
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