Organization
SELECT REHAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THEODORE ROBERSON (PHYSICAL THERAPIST ASSISTANT)
(301) 346-3202
Entity
Organization
Contact information
Practice address
1739 KIRBY RD, MC LEAN, VA 22101-4817
(703) 506-6900
Mailing address
11433 HAWKS RIDGE TER, GERMANTOWN, MD 20876-5502
(301) 346-3202
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
12/04/2020
Last updated
12/04/2020
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