Provider Demographics
NPI:1255758470
Name:MANASSAS HANDS-ON PHYSICAL THERAPY AND SPORTS MEDICINE INC
Entity type:Organization
Organization Name:MANASSAS HANDS-ON PHYSICAL THERAPY AND SPORTS MEDICINE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TAHA
Authorized Official - Middle Name:
Authorized Official - Last Name:ABDUR RAHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-349-9553
Mailing Address - Street 1:14645 SEASONS DR
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20120-6013
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9116 CENTER ST
Practice Address - Street 2:SUITE 104
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-5458
Practice Address - Country:US
Practice Address - Phone:703-349-9553
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-26
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy