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Individual

MADHURA A GURJAR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
2841 HARTLAND RD STE 403, FALLS CHURCH, VA 22043-3500
(703) 646-2250
(703) 991-5649
Mailing address
PO BOX 2901, MERRIFIELD, VA 22116-2901
(703) 646-2250
(703) 991-5649

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305205819
VA
225100000X
Physical Therapist
551012801
MI
225100000X
Physical Therapist
PT870994
DC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2307001242
DIRECT ACCESS CERTIFICATION
VA
05
30016439670001
VA
Enumeration date
05/04/2006
Last updated
04/17/2024
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