Provider Demographics
NPI:1649305277
Name:APPLIED PHYSICAL THERAPY, INC
Entity type:Organization
Organization Name:APPLIED PHYSICAL THERAPY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN ASST
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:KAMM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-830-8012
Mailing Address - Street 1:10373A DEMOCRACY LN
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-2505
Mailing Address - Country:US
Mailing Address - Phone:703-385-2855
Mailing Address - Fax:703-691-3127
Practice Address - Street 1:10373A DEMOCRACY LN
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-2505
Practice Address - Country:US
Practice Address - Phone:703-385-2855
Practice Address - Fax:703-691-3127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0557401-7261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy