Provider Demographics
NPI:1649817990
Name:PHYT COLLECTIVE, LLC
Entity type:Organization
Organization Name:PHYT COLLECTIVE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER & OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:SPEIGHTS
Authorized Official - Last Name:ONEILL
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:202-320-2306
Mailing Address - Street 1:1390 KENYON ST NW APT 726
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-7229
Mailing Address - Country:US
Mailing Address - Phone:202-320-2306
Mailing Address - Fax:
Practice Address - Street 1:818 CONNECTICUT AVE NW STE 500
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006-2713
Practice Address - Country:US
Practice Address - Phone:202-505-6300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-05
Last Update Date:2019-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy