Provider Demographics
NPI:1568840957
Name:ALLIANCE REHAB AND PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:ALLIANCE REHAB AND PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:NALINA
Authorized Official - Middle Name:
Authorized Official - Last Name:SRIKANTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-239-3200
Mailing Address - Street 1:5252 LYNGATE CT
Mailing Address - Street 2:SUITE 203
Mailing Address - City:BURKE
Mailing Address - State:VA
Mailing Address - Zip Code:22015-1672
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8316 ARLINGTON BLVD
Practice Address - Street 2:#600
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-5207
Practice Address - Country:US
Practice Address - Phone:703-205-1919
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-18
Last Update Date:2015-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305209399225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA2305209399OtherSTATE LICENSE NUMBER