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General NPI Number Information
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NPI Number | 1881488484
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Entity Type | Individual
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Provider Name | MATTHEW STEPHEN GRAESSLE DPT
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Gender | Male
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Dates
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Enumeration Date | 04/08/2025
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Last Update Date | 04/08/2025
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Provider Practice Location Address
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Address Line | 955 WONDER RD
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City | STAFFORD
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State | VA
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Zip | 22554-7798
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Country | US
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Telephone | 540-741-7891
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Fax |
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Provider Business Mailing Address
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Address Line | 301 MEADOW VIEW CT APT 303
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City | STAFFORD
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State | VA
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Zip | 22554-7732
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Country | US
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Telephone | 256-473-5150
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PTH10020
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License Number State | AL
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