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Organization

PROGRESSIVE PEDIATRIC THERAPY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. JILL KAREN WAGNER MS, PT (OWNER, PHYSICAL THERAPIST)
(703) 606-6213
Entity
Organization

Contact information

Practice address
150 S. WASHINGTON ST., #203, FALLS CHURCH, VA 22124
(703) 606-6213
(703) 496-4779
Mailing address
150 S WASHINGTON ST STE 203, FALLS CHURCH, VA 22046-2921
(703) 606-6213
(703) 496-4779

Taxonomy

Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
0105005106
VA

Other

Enumeration date
09/07/2018
Last updated
09/07/2018
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