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Organization
SHAPES PHYSICAL THERAPY & WELLNESS CLINIC LLC
Active
Organization
SHAPES PHYSICAL THERAPY & WELLNESS CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAISTA AMBREEN (CHIEF EXECUTIVE OFFICER)
(509) 212-9661
Entity
Organization
Contact information
Practice address
19441 GOLF VISTA PLZ STE 110, LEESBURG, VA 20176-8270
(509) 212-9661
Mailing address
825 FERNDALE TER NE, LEESBURG, VA 20176-4872
(509) 212-9661
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
02/02/2024
Last updated
02/02/2024
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