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General NPI Number Information
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NPI Number | 1790399400
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Entity Type | Organization
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Legal Business Name | WHOLEHEALTHPT LLC
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Dates
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Enumeration Date | 09/01/2020
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Last Update Date | 10/26/2020
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Provider Practice Location Address
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Address Line | 800 JOHN CARLYLE ST APT 124
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City | ALEXANDRIA
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State | VA
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Zip | 22314-6844
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Country | US
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Telephone | 262-818-7285
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Fax |
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Provider Business Mailing Address
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Address Line | 800 JOHN CARLYLE ST APT 124
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City | ALEXANDRIA
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State | VA
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Zip | 22314-6844
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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 | OWNER, PT
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Name | MRS. SARAH ELIZABETH EDMISTON CONTRADA
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Credential | DPT
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Telephone | 262-818-7285
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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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