MEDICARE: BREAKTHROUGH PHYSICAL THERAPY PLLC

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	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1316792526
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BREAKTHROUGH PHYSICAL THERAPY PLLC

Provider Business Mailing Address
First Line	:	1807 KEY BLVD APT 522
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22201-3235
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1807 KEY BLVD APT 522
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22201-3235
Country	:	US
Telephone Number	:	408-483-7128
Fax Number	:

Authorized Official
Title or Position	:	PHYSICAL THERAPIST
Name	:	SHERI JEAN
Credential	:
Telephone Number	:	408-483-7128

Provider Enumeration Date	:	04/22/2024
Last Update Date	:	04/22/2024

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