Doctor Name: | MRS. TRACY E BOLES |
NPI Number: | 1225337223 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DPT |
License Number: | 2305204913 |
Business Practice Address: | 3620 Joseph Siewick Dr Fairfax, VA - 220331756 |
Business Phone Number: | 7036483202 |
Business Fax Number: | 7036483830 |
Mailing Address: | 3620 Joseph Siewick Dr, FAIRFAX |
State: | VA |
Postal Code: | 220331756 |
Phone Number: | 7036483202 |
Fax Number: | 7036483830 |
NPI Enumeration Date: | 03/17/2011 |
NPI Last Update Date: | 03/17/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 2305204913 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |