Provider Demographics
NPI:1497407621
Name:ALEZZA PHYSICAL THERAPY CORP
Entity Type:Organization
Organization Name:ALEZZA PHYSICAL THERAPY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:D.P.T
Authorized Official - Prefix:
Authorized Official - First Name:KHALID
Authorized Official - Middle Name:
Authorized Official - Last Name:ATTIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-450-0569
Mailing Address - Street 1:41375 TARRAGON LEAF DR
Mailing Address - Street 2:
Mailing Address - City:ALDIE
Mailing Address - State:VA
Mailing Address - Zip Code:20105-5982
Mailing Address - Country:US
Mailing Address - Phone:201-450-0569
Mailing Address - Fax:
Practice Address - Street 1:41375 TARRAGON LEAF DR
Practice Address - Street 2:
Practice Address - City:ALDIE
Practice Address - State:VA
Practice Address - Zip Code:20105-5982
Practice Address - Country:US
Practice Address - Phone:201-450-0569
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-19
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy