MEDICARE: PHILIP JUSTICE

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
1	225100000X	Physical Therapist	2305209076	VA

General Provider Information

NPI Number	:	1154722734
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PHILIP JUSTICE

Provider Business Mailing Address
First Line	:	640 WARRIOR DR
Second Line	:	SUITE 115
City	:	STEPHENS CITY
State	:	VA
Zip	:	22655-4076
Country	:	US
Telephone Number	:	540-868-9599
Fax Number	:

Provider Business Practice Location Address
First Line	:	640 WARRIOR DR
Second Line	:	SUITE 115
City	:	STEPHENS CITY
State	:	VA
Zip	:	22655-4076
Country	:	US
Telephone Number	:	540-868-9599
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/15/2014
Last Update Date	:	09/15/2014

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Directions to “ PHILIP JUSTICE ” Practice Location

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