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NPI Code Detail

MEDICARE: MRS. ROSLYNN TRACI GARVIN PT

MEDICARE: MRS. ROSLYNN TRACI GARVIN PT
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 Therapist17201MD

General Provider Information

NPI Number : 1851424956
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ROSLYNN TRACI GARVIN PT
Provider Business Mailing Address
First Line : 49 E REED AVE
Second Line :
City : ALEXANDRIA
State : VA
Zip : 22305-3110
Country : US
Telephone Number : 703-548-1914
Fax Number :
Provider Business Practice Location Address
First Line : 8200 GOOD LUCK RD
Second Line :
City : LANHAM
State : MD
Zip : 20706-3511
Country : US
Telephone Number : 301-552-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2007
Last Update Date : 07/08/2007

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