Organization
MAC PHYSICAL THERAPY GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETER JOHN MACDANIEL DPT (OWNER)
(540) 424-5537
Entity
Organization
Contact information
Practice address
14 PIDGEON HILL DR STE 400, STERLING, VA 20165-6133
(703) 430-2371
(703) 430-1968
Mailing address
14 PIDGEON HILL DR STE 400, STERLING, VA 20165-6133
(703) 430-2371
(703) 430-1968
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
2305306771
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2305206771
LICENSE
VA
Enumeration date
04/18/2016
Last updated
03/17/2018
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