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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