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General NPI Number Information
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NPI Number | 1841669355
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Entity Type | Individual
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Provider Name | ZYKIA LARUE DPT
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Gender | Female
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Dates
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Enumeration Date | 09/15/2015
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Last Update Date | 12/21/2020
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Provider Practice Location Address
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Address Line | 507 17TH ST SE
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City | WASHINGTON
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State | DC
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Zip | 20003-3123
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Country | US
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Telephone | 202-417-6412
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Fax | 202-350-2456
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Provider Business Mailing Address
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Address Line | 507 17TH ST SE
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City | WASHINGTON
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State | DC
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Zip | 20003-3123
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Country | US
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Telephone | 202-417-6412
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Fax | 202-350-2456
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 25659
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License Number State | MD
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