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NPI Code Detail

MEDICARE: MEAGHAN RIEKE EVOLA PT

MEDICARE: MEAGHAN RIEKE EVOLA PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist2305211361VA
2225100000XPhysical Therapist26750MD

General Provider Information

NPI Number : 1124531223
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEAGHAN RIEKE EVOLA PT
Provider Business Mailing Address
First Line : 803 W BROAD ST STE 100
Second Line :
City : FALLS CHURCH
State : VA
Zip : 22046-3131
Country : US
Telephone Number : 571-378-1272
Fax Number :
Provider Business Practice Location Address
First Line : 803 W BROAD ST STE 100
Second Line :
City : FALLS CHURCH
State : VA
Zip : 22046-3131
Country : US
Telephone Number : 571-378-1272
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/10/2017
Last Update Date : 04/15/2020

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Directions to “ MEAGHAN RIEKE EVOLA PT” Practice Location

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