OrganizationActive
Active for Life Physical Therapy
NPI 1407494990 · Physical Therapist · Herndon, VA
Provider details
- NPI number
- 1407494990
- Entity type
- Organization
- Primary specialty
- Physical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Organization subpart
- No
- Authorized official
- Maude Bertovich, Physical Therapist(703) 597-4358
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
511 Fillmore St
Herndon, VA 20170-3314
Phone: (703) 249-9757
Fax: (703) 520-5485
Approximate (ZIP-level) locationGet directions
Mailing address
511 Fillmore St
Herndon, VA 20170-3314
Registry dates
- Enumerated
- 2019-12-15
- Last updated
- 2019-12-15
- Certified
- 2019-12-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.