MEDICARE: LITTLE RIVER PHYSICAL THERAPY 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	208100000X	Physical Medicine & Rehabilitation Physician
2	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1699396036
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LITTLE RIVER PHYSICAL THERAPY LLC

Provider Business Mailing Address
First Line	:	6321 OAK RIDGE DR
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22312-1237
Country	:	US
Telephone Number	:	571-276-9337
Fax Number	:	571-234-6232

Provider Business Practice Location Address
First Line	:	4216 EVERGREEN LN STE 121
Second Line	:
City	:	ANNANDALE
State	:	VA
Zip	:	22003-3256
Country	:	US
Telephone Number	:	571-276-9337
Fax Number	:	571-234-6232

Authorized Official
Title or Position	:	PHYSICAL THERAPIST
Name	:	LISA MARIE FISHER
Credential	:	PT
Telephone Number	:	571-276-9337

Provider Enumeration Date	:	04/27/2020
Last Update Date	:	05/01/2020

Similar Medicare Providers

1215425384 — PRIMARY GERONTOLOGY CENTER LLC
Practice Location Address:

4216 EVERGREEN LN STE 125
ANNANDALE, VA
22003-3256

Practice Phone: 571-206-1650
Practice Fax: 703-662-6165

1437314622 — LISA MARIE FISHER PT
Practice Location Address:

4216 EVERGREEN LN STE 121
ANNANDALE, VA
22003-3256

Practice Phone: 571-276-9337
Practice Fax: 571-234-6232

1811250293 — DR. JORGE I RAMALLO M.D.
Practice Location Address:

4216 EVERGREEN LN STE 121
ANNANDALE, VA
22003-3256

Practice Phone: 703-434-0749
Practice Fax: 888-671-8837

1497101885 — WOO HYUNG SHIN
Practice Location Address:

4216 EVERGREEN LN STE 121
ANNANDALE, VA
22003-3256

Practice Phone: 703-591-3333
Practice Fax:

1366043317 — GOLGOTA HEALTH SERVICES INC
Practice Location Address:

4216 EVERGREEN LN STE 133
ANNANDALE, VA
22003-3256

Practice Phone: 443-286-9323
Practice Fax:

1861191025 — TEN PRO CLINIC
Practice Location Address:

4216 EVERGREEN LN STE 121
ANNANDALE, VA
22003-3256

Practice Phone: 703-829-6162
Practice Fax: 703-662-6165

Directions to “LITTLE RIVER PHYSICAL THERAPY LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.