Organization
BOUNDLESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FAYOLA ETIENNE DPT (OWNER)
(862) 371-8510
Entity
Organization
Contact information
Practice address
148 T ST NE, WASHINGTON, DC 20002-1579
(862) 371-8510
Mailing address
148 T ST NE, WASHINGTON, DC 20002-1579
(862) 371-8510
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
09/04/2024
Last updated
09/04/2024
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