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General NPI Number Information
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NPI Number | 1639046790
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Entity Type | Organization
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Legal Business Name | THE GLUTE INSTITUTE, LLC
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Dates
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Enumeration Date | 10/22/2025
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Last Update Date | 10/22/2025
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Provider Practice Location Address
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Address Line | 277 SUNSET PARK DR
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City | HERNDON
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State | VA
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Zip | 20170-5220
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Country | US
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Telephone | 703-344-7540
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Fax |
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Provider Business Mailing Address
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Address Line | 12402 ROCK RIDGE RD
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City | HERNDON
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State | VA
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Zip | 20170-5720
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Country | US
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Telephone | 571-277-8664
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | IAN MICHAEL SLATTERY
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Credential | PT, DPT, OCS
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Telephone | 571-277-8664
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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 |
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License Number State |
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