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General NPI Number Information
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NPI Number | 1962963280
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Entity Type | Organization
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Legal Business Name | MANUAL MEDICINE SPINE AND SPORTS PHYSICAL THERAPY
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Dates
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Enumeration Date | 03/28/2019
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Last Update Date | 03/28/2019
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Provider Practice Location Address
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Address Line | 1015 15TH ST NW, STE 614K
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City | WASHINGTON
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State | DC
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Zip | 20005
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Country | US
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Telephone | 202-670-8874
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Fax |
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Provider Business Mailing Address
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Address Line | 833 DECATUR ST NW
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City | WASHINGTON
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State | DC
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Zip | 20011
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Country | US
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Telephone | 202-670-8874
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Fax |
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Authorized Official
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Title or Position | REPRESENTATIVE
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Name | MS. TRUPTI BIPINCHANDRA MEHTA
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Credential | PT
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Telephone | 919-302-5091
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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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