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General NPI Number Information
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NPI Number | 1932966991
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Entity Type | Organization
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Legal Business Name | FIERCE FRIENDS THERAPY, PLLC
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Dates
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Enumeration Date | 03/05/2024
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Last Update Date | 03/05/2024
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Provider Practice Location Address
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Address Line | 9109 GLENBROOK RD
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City | FAIRFAX
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State | VA
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Zip | 22031-3008
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Country | US
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Telephone | 703-261-9491
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Fax | 276-409-6203
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Provider Business Mailing Address
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Address Line | 9109 GLENBROOK RD
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City | FAIRFAX
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State | VA
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Zip | 22031-3008
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Country | US
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Telephone | 703-261-9491
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Fax | 276-409-6203
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Authorized Official
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Title or Position | OWNER/PHYSICAL THERAPIST
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Name | LORELEI FRIENDS THERAPY LASH
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Credential | PT
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Telephone | 703-447-7278
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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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