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NPI Code Detail

MEDICARE: EMILY CLEVELAND DPT

MEDICARE: EMILY CLEVELAND DPT
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 Therapist2305212959VA

General Provider Information

NPI Number : 1629621719
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY CLEVELAND DPT
Provider Business Mailing Address
First Line : 10716 RICHMOND HWY STE 103
Second Line :
City : LORTON
State : VA
Zip : 22079-2645
Country : US
Telephone Number : 703-892-6500
Fax Number : 703-521-3415
Provider Business Practice Location Address
First Line : 10716 RICHMOND HWY STE 103
Second Line :
City : LORTON
State : VA
Zip : 22079-2645
Country : US
Telephone Number : 703-892-6500
Fax Number : 703-521-3415
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2019
Last Update Date : 03/15/2024

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Directions to “ EMILY CLEVELAND DPT” Practice Location

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