Evergreen Clinic, Pllc

NPI #1265954960 in Gainesville, Virginia

Provider Information

NPI Number: 1265954960
Entity Type: Organization
Organization Name: Evergreen Clinic, Pllc
Primary Specialty: Physical Therapist
Enumeration Date: Jul 13, 2017
Last Updated: Jul 13, 2017

Practice Location

Address: 14540 JOHN MARSHALL HWY STE 202
City: Gainesville
State: Virginia
ZIP Code: 20155-1693
Phone: (703) 753-9700

Authorized Official

Name: MRS. JACQUELINE STILES, DPT
Title: PHYSICAL THERAPIST
Phone: (443) 622-9641

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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