Provider Demographics
NPI:1730687484
Name:HEAD, SHOULDERS, KNEES AND TOES PT
Entity type:Organization
Organization Name:HEAD, SHOULDERS, KNEES AND TOES PT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ALYSON
Authorized Official - Middle Name:
Authorized Official - Last Name:FLIAKAS
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:703-868-0628
Mailing Address - Street 1:5437 20TH ST N
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22205-3020
Mailing Address - Country:US
Mailing Address - Phone:703-868-0628
Mailing Address - Fax:703-536-5391
Practice Address - Street 1:5437 20TH ST N
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22205-3020
Practice Address - Country:US
Practice Address - Phone:703-868-0628
Practice Address - Fax:703-536-5391
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-29
Last Update Date:2018-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305203364261QP2000X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Single Specialty