Provider Demographics
NPI:1891160735
Name:MATHIAS, HUNTER DANIEL (DPT, PT, ATC, AEMT)
Entity Type:Individual
Prefix:DR
First Name:HUNTER
Middle Name:DANIEL
Last Name:MATHIAS
Suffix:
Gender:M
Credentials:DPT, PT, ATC, AEMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1769
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20118-1769
Mailing Address - Country:US
Mailing Address - Phone:703-689-3164
Mailing Address - Fax:703-689-3167
Practice Address - Street 1:13039 WORLDGATE DR
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20170-4374
Practice Address - Country:US
Practice Address - Phone:703-689-3164
Practice Address - Fax:703-689-3167
Is Sole Proprietor?:No
Enumeration Date:2015-12-03
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2255A2300X
VA2305213021225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer