Individual
GARY YAGODA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
8300 GREENSBORO DR, LL 100, MC LEAN, VA 22102-3605
(703) 556-8477
Mailing address
2251 PIMMIT DR, 1229, FALLS CHURCH, VA 22043-2811
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305202367
VA
Other
Enumeration date
07/17/2007
Last updated
07/17/2007
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