Provider Demographics
NPI:1467565333
Name:HILLTOP PHYSICAL THERAPY, INC.
Entity Type:Organization
Organization Name:HILLTOP PHYSICAL THERAPY, INC.
Other - Org Name:HILLTOP PHYSICAL THERAPY, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:
Authorized Official - Last Name:PARK
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:540-899-0002
Mailing Address - Street 1:605 JEFFERSON DAVIS HWY
Mailing Address - Street 2:SUITE 202
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-8403
Mailing Address - Country:US
Mailing Address - Phone:540-899-0002
Mailing Address - Fax:540-899-0082
Practice Address - Street 1:605 JEFFERSON DAVIS HWY
Practice Address - Street 2:SUITE 202
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-8403
Practice Address - Country:US
Practice Address - Phone:540-899-0002
Practice Address - Fax:540-899-0082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-16
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0105004332174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA009403256Medicaid
VA009403256Medicaid
VADB6609Medicare PIN