Organization
GREAT FALLS PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY JEAN STACK PT (OWNER)
(703) 349-1030
Entity
Organization
Contact information
Practice address
766 WALKER RD STE B, GREAT FALLS, VA 22066-2650
(703) 349-1030
(703) 364-5124
Mailing address
766 WALKER RD STE B, GREAT FALLS, VA 22066-2650
(703) 349-1030
(703) 364-5124
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1508262734
NPI
—
Enumeration date
09/08/2019
Last updated
07/17/2020
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