Blue Room Pt Inc.

NPI #1902331085 in Vienna, Virginia

Provider Information

NPI Number: 1902331085
Entity Type: Organization
Organization Name: Blue Room Pt Inc.
Primary Specialty: Physical Therapist
Enumeration Date: Apr 26, 2017
Last Updated: Apr 26, 2017

Practice Location

Address: 8530 AMANDA PL
City: Vienna
State: Virginia
ZIP Code: 22180-6873
Phone: (240) 505-5544

Authorized Official

Name: MR. CONRAD SULTAN OSIPOWICZ
Title: PRESIDENT
Phone: (240) 505-5544

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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