Provider Demographics
NPI:1881496537
Name:SISU PHYSIOTHERAPY PLLC
Entity type:Organization
Organization Name:SISU PHYSIOTHERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAISON
Authorized Official - Middle Name:W
Authorized Official - Last Name:ALDERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:571-474-3292
Mailing Address - Street 1:PO BOX 861414
Mailing Address - Street 2:
Mailing Address - City:VINT HILL FARMS
Mailing Address - State:VA
Mailing Address - Zip Code:20187-1414
Mailing Address - Country:US
Mailing Address - Phone:571-474-3292
Mailing Address - Fax:571-474-3292
Practice Address - Street 1:6801 KENNEDY RD STE 100
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20187-3996
Practice Address - Country:US
Practice Address - Phone:571-474-3292
Practice Address - Fax:571-474-3292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-25
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy