MEDICARE: ATHLETE S PHYSICAL THERAPIST LLC

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

General Provider Information

NPI Number	:	1386429660
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATHLETE S PHYSICAL THERAPIST LLC

Provider Business Mailing Address
First Line	:	7505 GLEBE RD
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23229-5909
Country	:	US
Telephone Number	:	757-344-8979
Fax Number	:

Provider Business Practice Location Address
First Line	:	7505 GLEBE RD
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23229-5909
Country	:	US
Telephone Number	:	757-344-8979
Fax Number	:

Authorized Official
Title or Position	:	ENTITY
Name	:	ZENBUSINESS INC
Credential	:	N/A
Telephone Number	:	844-493-6249

Provider Enumeration Date	:	08/25/2023
Last Update Date	:	08/25/2023

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Directions to “ATHLETE S PHYSICAL THERAPIST LLC ” Practice Location

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