Organization
IDEAL WELLNESS, PLLC
Active
Organization
IDEAL WELLNESS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTY BLAIR DPT (OWNER)
(860) 608-5019
Entity
Organization
Contact information
Practice address
3310 NOBLE POND WAY STE 215, WOODBRIDGE, VA 22193-1472
(571) 989-2001
(571) 376-7015
Mailing address
16004 NORMANDY CT, WOODBRIDGE, VA 22191-4321
(571) 989-2001
(571) 376-7015
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
2305207764
VA
Other
Enumeration date
05/23/2016
Last updated
02/23/2021
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