Provider Demographics
NPI:1164629119
Name:ARTHRITIS & SPORTS ORTHOPEDICS
Entity Type:Organization
Organization Name:ARTHRITIS & SPORTS ORTHOPEDICS
Other - Org Name:ARTHRITIS & SPORTS PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RANDALL
Authorized Official - Middle Name:
Authorized Official - Last Name:PEYTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-444-5000
Mailing Address - Street 1:21475 RIDGETOP CIR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20166-6580
Mailing Address - Country:US
Mailing Address - Phone:703-433-2500
Mailing Address - Fax:703-433-2558
Practice Address - Street 1:21475 RIDGETOP CIR
Practice Address - Street 2:SUITE 100
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20166-6580
Practice Address - Country:US
Practice Address - Phone:703-433-2500
Practice Address - Fax:703-433-2558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305002558225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty