Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 230 | VA |
NPI | 1215390042 |
---|---|
Provider Name | Debbie Flint |
First Address | Fairfax, VA 22032-1820 |
Second Address | Fairfax, VA 22032-1820 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2016 |
Last Update Date | 30/03/2016 |