MEDICARE: MR. DAVID NOEL FELTWELL MPT

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	0400003330	VT

General Provider Information

NPI Number	:	1548232721
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DAVID NOEL FELTWELL MPT

Provider Business Mailing Address
First Line	:	8910 GRANDSTAFF CT
Second Line	:
City	:	SPRINGFIELD
State	:	VA
Zip	:	22153-1119
Country	:	US
Telephone Number	:	703-644-0409
Fax Number	:

Provider Business Practice Location Address
First Line	:	PHYSICAL THERAPY SECTION
Second Line	:	DILORENZO TRICARE HEALTH CLINIC
City	:	WASHINGTON
State	:	DC
Zip	:	20310-0001
Country	:	US
Telephone Number	:	703-692-8982
Fax Number	:

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

Provider Enumeration Date	:	02/02/2006
Last Update Date	:	07/08/2007

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