Provider Demographics
NPI:1114469848
Name:ALPHA PHYSICAL AND AQUATIC THERAPY LLC
Entity type:Organization
Organization Name:ALPHA PHYSICAL AND AQUATIC THERAPY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANGER
Authorized Official - Prefix:
Authorized Official - First Name:MUHAMMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:JAHANGIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-587-3171
Mailing Address - Street 1:5860 COLUMBIA PIKE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22041-2038
Mailing Address - Country:US
Mailing Address - Phone:571-366-5900
Mailing Address - Fax:703-998-4060
Practice Address - Street 1:5860 COLUMBIA PIKE
Practice Address - Street 2:SUITE 104
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22041-2038
Practice Address - Country:US
Practice Address - Phone:571-366-5900
Practice Address - Fax:703-998-4060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-11
Last Update Date:2017-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty