Individual
NATHAN LOUIS SLADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10701 MAIN ST, FAIRFAX, VA 22030-6904
(703) 273-7705
Mailing address
2911 DEER HOLLOW WAY UNIT 418, FAIRFAX, VA 22031-6048
(757) 903-1411
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306605670
VA
Other
Enumeration date
08/10/2020
Last updated
08/12/2020
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