Provider Demographics
NPI:1407244338
Name:PTFITDC, LLC
Entity Type:Organization
Organization Name:PTFITDC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:D'ANGELO
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:734-277-0242
Mailing Address - Street 1:2791 CENTERBORO DR
Mailing Address - Street 2:#286
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22181-4818
Mailing Address - Country:US
Mailing Address - Phone:734-277-0242
Mailing Address - Fax:
Practice Address - Street 1:2791 CENTERBORO DR
Practice Address - Street 2:#286
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22181-4818
Practice Address - Country:US
Practice Address - Phone:734-277-0242
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-30
Last Update Date:2014-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305209170225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty