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General NPI Number Information
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NPI Number | 1639292295
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Entity Type | Organization
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Legal Business Name | PRO MOTION PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 04/09/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6849 OLD DOMINION DR SUITE 221
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City | MCLEAN
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State | VA
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Zip | 22101-3724
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Country | US
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Telephone | 703-848-9333
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Fax | 703-848-0660
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Provider Business Mailing Address
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Address Line | 6849 OLD DOMINION DR SUITE 221
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City | MCLEAN
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State | VA
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Zip | 22101-3724
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Country | US
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Telephone | 703-848-9333
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Fax | 703-848-0660
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Authorized Official
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Title or Position | CO-OWNER
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Name | PUJA CHARAIPOTRA
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Credential | P.T.
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Telephone | 703-848-9333
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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 | VA
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