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General NPI Number Information
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NPI Number | 1962592691
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Entity Type | Organization
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Legal Business Name | PEDIATRIC THERAPY SPECIALISTS, PLC
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Dates
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Enumeration Date | 10/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9673 MAIN ST STE A
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City | FAIRFAX
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State | VA
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Zip | 22031-3761
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Country | US
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Telephone | 703-503-5300
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Fax | 703-503-5387
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Provider Business Mailing Address
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Address Line | 9673 MAIN ST STE A
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City | FAIRFAX
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State | VA
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Zip | 22031-3761
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Country | US
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Telephone | 703-503-5300
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Fax | 703-503-5387
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Authorized Official
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Title or Position | OWNER
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Name | MRS. NATASHA NELAM MALHOTRA
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Credential | MSOTR L
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Telephone | 703-503-5300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | VA
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