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General NPI Number Information
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NPI Number | 1902784390
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Entity Type | Individual
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Provider Name | MADELINE A VLATTAS DPT
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Gender | Female
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Dates
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Enumeration Date | 08/25/2025
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 1945 OLD GALLOWS RD STE 100
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City | VIENNA
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State | VA
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Zip | 22182-3931
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Country | US
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Telephone | 301-701-3010
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Fax |
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Provider Business Mailing Address
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Address Line | 13173 NEW PARKLAND DR
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City | HERNDON
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State | VA
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Zip | 20171-3824
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Country | US
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Telephone | 703-464-5411
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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 | 2305217369
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License Number State | VA
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