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Organization

IMMACULATE PHYSICAL THERAPY PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. DALIA M ELASHKER PHYSICAL THERAPIST (DIRECTOR)
(703) 309-7028
Entity
Organization

Contact information

Practice address
117 CASMAR ST SE, VIENNA, VA 22180-6610
(703) 309-7028
(800) 928-5061
Mailing address
117 CASMAR ST SE, VIENNA, VA 22180-6610
(703) 309-7028
(800) 928-5061

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
2305204191
VA
225100000X
Physical Therapist
Primary
2305205493
VA

Other

Enumeration date
04/21/2010
Last updated
04/21/2010
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