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General NPI Number Information
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NPI Number | 1811479959
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Entity Type | Individual
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Provider Name | CAROLYN DRISLANE PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 09/05/2018
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Last Update Date | 10/24/2023
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Provider Practice Location Address
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Address Line | 9300 DEWITT LOOP
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City | FT BELVOIR
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State | VA
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Zip | 22060-5285
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Country | US
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Telephone | 712-312-2905
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Fax |
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Provider Business Mailing Address
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Address Line | 4710 31ST ST S
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City | ARLINGTON
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State | VA
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Zip | 22206-1608
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Country | US
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Telephone | 518-817-2687
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 2305212289
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 2305212289
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License Number State | VA
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