Provider Demographics
NPI:1205370020
Name:VIRGINIAN PHYSICAL THERAPY &STAFFING, LLC
Entity Type:Organization
Organization Name:VIRGINIAN PHYSICAL THERAPY &STAFFING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF PHYSICAL THERAPY
Authorized Official - Prefix:
Authorized Official - First Name:ALIYAT
Authorized Official - Middle Name:
Authorized Official - Last Name:YIMAM
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:202-870-4996
Mailing Address - Street 1:20 PIDGEON HILL DR
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20165-6154
Mailing Address - Country:US
Mailing Address - Phone:202-870-4996
Mailing Address - Fax:
Practice Address - Street 1:20 PIDGEON HILL DR
Practice Address - Street 2:SUITE 103
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20165-6134
Practice Address - Country:US
Practice Address - Phone:202-870-4996
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-13
Last Update Date:2020-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305205266261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy