Organization
LAKE RIDGE PHYSICAL THERAPY, LLC
Active
Organization
LAKE RIDGE PHYSICAL THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BECKY S ANDERSON (VICE PRESIDENT/PRACTICE MANAGER)
(703) 730-6969
Entity
Organization
Contact information
Practice address
12544 DILLINGHAM SQ, WOODBRIDGE, VA 22192-5259
(703) 730-6969
(703) 730-1169
Mailing address
12544 DILLINGHAM SQ, WOODBRIDGE, VA 22192-5259
(703) 730-6969
(703) 730-1169
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
2305003338
VA
225100000X
Physical Therapist
2305003984
VA
225100000X
Physical Therapist
2305004144
VA
225100000X
Physical Therapist
Primary
2305004216
VA
225100000X
Physical Therapist
2305006554
VA
225100000X
Physical Therapist
2305202401
VA
225100000X
Physical Therapist
2305204490
VA
225100000X
Physical Therapist
2305207715
VA
225100000X
Physical Therapist
2306602599
VA
225100000X
Physical Therapist
2306602710
VA
225100000X
Physical Therapist
2306602926
VA
225100000X
Physical Therapist
2306603587
VA
225100000X
Physical Therapist
2306603592
VA
225100000X
Physical Therapist
2306603622
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1871598417
—
VA
01
—
S427
CAREFIRST
—
Enumeration date
06/20/2005
Last updated
09/14/2022
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