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General NPI Number Information
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NPI Number | 1871370247
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Entity Type | Organization
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Legal Business Name | BELTWAY MEDICAL GROUP
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Dates
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Enumeration Date | 09/11/2023
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Last Update Date | 02/07/2024
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Provider Practice Location Address
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Address Line | 12011 ROUTE 50 STE 103
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City | FAIRFAX
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State | VA
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Zip | 22033-3323
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Country | US
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Telephone | 703-232-2524
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Fax |
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Provider Business Mailing Address
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Address Line | 12011 ROUTE 50 STE 103
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City | FAIRFAX
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State | VA
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Zip | 22033-3323
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Country | US
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Telephone | 703-232-2524
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Fax | 571-340-3304
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Authorized Official
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Title or Position | MANAGER
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Name | JOSHUA YAUGER
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Credential |
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Telephone | 703-459-7759
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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 |
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License Number State |
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