Organization
J.A.W. THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAYAN HAGONA-WORDIE PT (CEO)
(832) 818-2751
Entity
Organization
Contact information
Practice address
714 55TH ST NE, WASHINGTON, DC 20019-6712
(832) 818-2751
Mailing address
714 55TH ST NE, WASHINGTON, DC 20019-6712
(832) 818-2751
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
871597
PT LICENSE
DC
Enumeration date
09/17/2020
Last updated
09/30/2020
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