Individual
ELLENI ESTIFANOS TEKLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
7223 COMMERCE ST, SPRINGFIELD, VA 22150-3411
(703) 935-1999
Mailing address
7363 STREAM WAY, SPRINGFIELD, VA 22152-3638
(703) 347-2535
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305211629
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C69606099
VIRGINIA DRIVER'S LICENSE
VA
Enumeration date
01/09/2018
Last updated
08/27/2021
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