Organization
ACTIVE FOR LIFE PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAUDE BERTOVICH PT, DPT (PHYSICAL THERAPIST)
(703) 597-4358
Entity
Organization
Contact information
Practice address
511 FILLMORE ST, HERNDON, VA 20170-3314
(703) 249-9757
(703) 520-5485
Mailing address
511 FILLMORE ST, HERNDON, VA 20170-3314
(703) 597-4358
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
12/15/2019
Last updated
12/15/2019
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