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General NPI Number Information
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NPI Number | 1679719421
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Entity Type | Organization
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Legal Business Name | FAST TRACK PHYSICAL THERAPY & SPORTS PERFORMANCE
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Dates
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Enumeration Date | 12/29/2008
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Last Update Date | 12/29/2008
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Provider Practice Location Address
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Address Line | 402 W BROAD ST FL 2
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City | FALLS CHURCH
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State | VA
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Zip | 22046-3337
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Country | US
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Telephone | 703-346-6517
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 7403
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City | FALLS CHURCH
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State | VA
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Zip | 22040-7403
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | FOUNDER, PHYSICAL THERAPIST
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Name | KERRI LYNN KRAMER
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Credential | MSPT
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Telephone | 703-346-6517
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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 | 2305204391
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License Number State | VA
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