Organization
AERODREAM LLC
Active
Other names
Blue Room Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CONRAD SULTAN OSIPOWICZ (PRESIDENT)
(240) 505-5544
Entity
Organization
Contact information
Practice address
8530 AMANDA PL, VIENNA, VA 22180-6873
(240) 505-5544
(301) 365-4203
Mailing address
13505 DULLES TECHNOLOGY DR, SUITE 2, HERNDON, VA 20171-3401
(240) 505-5544
(301) 365-4203
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305205179
VA
Other
Enumeration date
11/18/2008
Last updated
11/29/2016
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