Provider Demographics
NPI:1023622438
Name:VIRTUAL PHYSIO, LLC
Entity type:Organization
Organization Name:VIRTUAL PHYSIO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CAMERON
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:MASSUMI
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, CMTPT
Authorized Official - Phone:703-828-0582
Mailing Address - Street 1:46558 BROADSPEAR TER
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20165
Mailing Address - Country:US
Mailing Address - Phone:703-828-0582
Mailing Address - Fax:
Practice Address - Street 1:46558 BROADSPEAR TER
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20165-3217
Practice Address - Country:US
Practice Address - Phone:703-828-0582
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-02
Last Update Date:2023-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty