Organization
INTEGRATIVE PHYSICAL THERAPY AND WELLNESS
Active
Organization
INTEGRATIVE PHYSICAL THERAPY AND WELLNESS
Active
Parent organization
INTEGRATIVE PHYSICAL THERAPY AND WELLNESS
Organization subpart
Yes
Provider details
NPI number
Legal business name
INTEGRATIVE PHYSICAL THERAPY AND WELLNESS
Authorized official
DR. STACY KEITH DPT, PT (PRESIDENT/CEO)
(703) 786-8827
Entity
Organization
Contact information
Practice address
512 HERNDON PKWY STE F, SUITE 120, HERNDON, VA 20170-5244
(786) 882-7786
Mailing address
512 HERNDON PARKWAY, SUITE F, HERNDON, VA 20170
(703) 786-8827
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
2307000500
VA
Other
Enumeration date
03/24/2011
Last updated
05/12/2014
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