Active for Life Physical Therapy

NPI #1407494990 in Herndon, Virginia

Provider Information

NPI Number: 1407494990
Entity Type: Organization
Organization Name: Active for Life Physical Therapy
Primary Specialty: Physical Therapist
Enumeration Date: Dec 15, 2019
Last Updated: Dec 15, 2019

Practice Location

Address: 511 FILLMORE ST
City: Herndon
State: Virginia
ZIP Code: 20170-3314
Phone: (703) 249-9757

Authorized Official

Name: MAUDE BERTOVICH, PT, DPT
Title: PHYSICAL THERAPIST
Phone: (703) 597-4358

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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