Organization
NOVA SPORTS AND SPINE PHYSICAL THERAPY
Active
Organization
NOVA SPORTS AND SPINE PHYSICAL THERAPY
Active
Other names
Nova Sports and Spine Rehab
Organization subpart
No
Provider details
NPI number
Authorized official
LORENZ FORTUNO (PHYSICAL THERAPIST)
(571) 594-4615
Entity
Organization
Contact information
Practice address
7724 HAYFIELD RD, ALEXANDRIA, VA 22315-4052
(703) 971-2069
Mailing address
7724 HAYFIELD RD, ALEXANDRIA, VA 22315-4052
(703) 971-2069
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
2305202501
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1982609541
NATIONAL PROVIDER IDENTIFIER
VA
Enumeration date
05/21/2016
Last updated
05/21/2016
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