Provider Demographics
NPI:1447615661
Name:PEOPLE TRUST PHYSICAL THERAPY, P.C.
Entity Type:Organization
Organization Name:PEOPLE TRUST PHYSICAL THERAPY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUNGNYU
Authorized Official - Middle Name:S
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:703-626-1465
Mailing Address - Street 1:3102 MEREWORTH CT
Mailing Address - Street 2:
Mailing Address - City:OAKTON
Mailing Address - State:VA
Mailing Address - Zip Code:22124-1758
Mailing Address - Country:US
Mailing Address - Phone:703-626-1465
Mailing Address - Fax:
Practice Address - Street 1:6860 COMMERCIAL DR
Practice Address - Street 2:SUIT #C
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22151-4201
Practice Address - Country:US
Practice Address - Phone:703-626-1465
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-15
Last Update Date:2015-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305203083261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy