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Individual

VIPULA PUNTIKURA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHYSICAL THERAPIST A

Contact information

Practice address
12475 LEE JACKSON MEMORIAL HWY, FAIRFAX, VA 22033-2803
(571) 337-6687
Mailing address
9672 CEDAR FARM CIR, FAIRFAX, VA 22031-5404
(571) 337-6687

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306604030
VA

Other

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