Provider Demographics
NPI:1124873054
Name:RESILIENT PHYSICAL THERAPY AND WELLNESS, PLLC
Entity type:Organization
Organization Name:RESILIENT PHYSICAL THERAPY AND WELLNESS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PT
Authorized Official - Prefix:
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:OROURKE
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:703-261-9947
Mailing Address - Street 1:1213 FALSTER CT
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22308-1808
Mailing Address - Country:US
Mailing Address - Phone:315-591-1926
Mailing Address - Fax:
Practice Address - Street 1:1213 FALSTER CT
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22308-1808
Practice Address - Country:US
Practice Address - Phone:703-261-9947
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-23
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No251E00000XAgenciesHome Health