Provider Demographics
NPI:1689455081
Name:MOTT, WILLIAM (DPT)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:MOTT
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14383 SILO VALLEY VW
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20121-2354
Mailing Address - Country:US
Mailing Address - Phone:904-460-7488
Mailing Address - Fax:
Practice Address - Street 1:10940 FAIRFAX BLVD STE D1
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-4301
Practice Address - Country:US
Practice Address - Phone:571-321-5430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-11
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist