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NPI Code Detail

MEDICARE: MRS. MARIA CECILIA GRADY P.T.

MEDICARE: MRS. MARIA CECILIA GRADY P.T.
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
12251P0200XPediatric Physical Therapist2305005036VA

General Provider Information

NPI Number : 1831193119
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARIA CECILIA GRADY P.T.
Provider Business Mailing Address
First Line : 906 TRAILVIEW BLVD SE STE A
Second Line :
City : LEESBURG
State : VA
Zip : 20175-4415
Country : US
Telephone Number : 703-737-8099
Fax Number :
Provider Business Practice Location Address
First Line : 906 TRAILVIEW BLVD SE STE A
Second Line :
City : LEESBURG
State : VA
Zip : 20175-4415
Country : US
Telephone Number : 703-737-8099
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2005
Last Update Date : 09/12/2007

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Directions to “ MRS. MARIA CECILIA GRADY P.T.” Practice Location

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