Individual
TYRUS POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
7617 LITTLE RIVER TPKE, SUITE 310, ANNANDALE, VA 22003-2603
(703) 750-2443
Mailing address
7617 LITTLE RIVER TPKE, SUITE 310, ANNANDALE, VA 22003-2603
(703) 750-2443
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
0119003123
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0119003123
VIRGINIA BOARD OF MEDICINE
VA
Enumeration date
04/14/2009
Last updated
04/14/2009
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