Provider Demographics
NPI:1912421108
Name:NR PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:NR PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KYUNG
Authorized Official - Middle Name:H
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-342-2612
Mailing Address - Street 1:13890 BRADDOCK RD STE 103
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20121-2436
Mailing Address - Country:US
Mailing Address - Phone:703-266-7779
Mailing Address - Fax:703-266-7774
Practice Address - Street 1:13890 BRADDOCK RD STE 103
Practice Address - Street 2:
Practice Address - City:CENTREVILLE
Practice Address - State:VA
Practice Address - Zip Code:20121-2436
Practice Address - Country:US
Practice Address - Phone:703-266-7779
Practice Address - Fax:703-266-7774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty