Organization
PROACTIVE PHYSICAL THERAPY AND WELLNESS LLC
Active
Organization
PROACTIVE PHYSICAL THERAPY AND WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHAVONE JOHNSON (PHYSICAL THERAPIST)
(571) 294-3557
Entity
Organization
Contact information
Practice address
3903 FAIR RIDGE DR, 211, FAIRFAX, VA 22033-2943
(571) 294-3557
Mailing address
3903 FAIR RIDGE DR, 211, FAIRFAX, VA 22033-2943
(571) 294-3557
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
2305204873
VA
Other
Enumeration date
03/09/2015
Last updated
08/03/2015
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