Provider Demographics
NPI:1568702371
Name:NOVA PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:NOVA PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ASIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:AFTAB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-266-0738
Mailing Address - Street 1:8191 STRAWBERRY LN
Mailing Address - Street 2:SUITE # 6
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-1031
Mailing Address - Country:US
Mailing Address - Phone:301-266-0738
Mailing Address - Fax:
Practice Address - Street 1:11154 BUNCHBERRY CT
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20601-2631
Practice Address - Country:US
Practice Address - Phone:301-266-0738
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-15
Last Update Date:2013-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305206276174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty