Provider Demographics
NPI:1659523488
Name:ACCESS PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:ACCESS PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:FAROUK
Authorized Official - Middle Name:
Authorized Official - Last Name:ELKASSED
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:703-865-5538
Mailing Address - Street 1:10340 DEMOCRACY LN
Mailing Address - Street 2:SUITE 106
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-2518
Mailing Address - Country:US
Mailing Address - Phone:703-865-5538
Mailing Address - Fax:703-865-5630
Practice Address - Street 1:10340 DEMOCRACY LN
Practice Address - Street 2:SUITE 106
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-2518
Practice Address - Country:US
Practice Address - Phone:703-865-5538
Practice Address - Fax:703-865-5530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-10
Last Update Date:2008-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305004573225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty