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General NPI Number Information
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NPI Number | 1902221740
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Entity Type | Organization
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Legal Business Name | PURCELLVILLE ORTHOPEDIC PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 03/04/2014
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Last Update Date | 06/13/2014
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Provider Practice Location Address
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Address Line | 850C E MAIN ST
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City | PURCELLVILLE
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State | VA
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Zip | 20132-3163
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Country | US
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Telephone | 540-751-1970
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Fax | 540-751-1971
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Provider Business Mailing Address
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Address Line | 850C E MAIN ST
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City | PURCELLVILLE
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State | VA
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Zip | 20132-3163
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Country | US
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Telephone | 540-751-1970
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Fax | 540-751-1971
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Authorized Official
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Title or Position | OWNER
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Name | MR. EARL FORBES COX III
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Credential | PT, MS
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Telephone | 301-788-2768
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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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