Provider Demographics
NPI:1174605687
Name:HAYMARKET PHYSICAL THERAPY
Entity type:Organization
Organization Name:HAYMARKET PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN'S ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SAGLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-880-9856
Mailing Address - Street 1:14535 JOHN MARSHALL HIGHWAY
Mailing Address - Street 2:SUITE 203
Mailing Address - City:GAINESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20155
Mailing Address - Country:US
Mailing Address - Phone:703-753-0974
Mailing Address - Fax:703-753-9709
Practice Address - Street 1:14535 JOHN MARSHALL HIGHWAY
Practice Address - Street 2:SUITE 203
Practice Address - City:GAINESVILLE
Practice Address - State:VA
Practice Address - Zip Code:20155
Practice Address - Country:US
Practice Address - Phone:703-753-0974
Practice Address - Fax:703-753-9709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty