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General NPI Number Information
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NPI Number | 1639106073
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Entity Type | Organization
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Legal Business Name | JOHN H AND CATHY R FEDER
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Dates
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Enumeration Date | 06/28/2006
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Last Update Date | 06/17/2008
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Provider Practice Location Address
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Address Line | 3345 DUKE ST
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City | ALEXANDRIA
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State | VA
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Zip | 22314-5219
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Country | US
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Telephone | 703-370-4093
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Fax | 703-370-4093
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Provider Business Mailing Address
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Address Line | 8514 BOUND BROOK LN
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City | ALEXANDRIA
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State | VA
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Zip | 22309-2114
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Country | US
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Telephone | 703-780-0631
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Fax |
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Authorized Official
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Title or Position | OWNER/CHIEF PHYSICAL THERAPIST
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Name | MS. CATHY RICHARDSON FEDER
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Credential | RPT
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Telephone | 703-370-4093
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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 | 2305001645
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License Number State | VA
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