OrganizationActive
Sports Enhancement Physical Therapy
NPI 1508480518 · Sports Physical Therapist · Locust Grove, VA
Provider details
- NPI number
- 1508480518
- Entity type
- Organization
- Primary specialty
- Sports Physical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Organization subpart
- No
- Authorized official
- Kimberly-Kay Wynn, Owner(540) 308-3358
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
- Physical Therapist225100000X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
- Orthopedic Physical Therapist2251X0800X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
2607 Lakeview Pkwy
Locust Grove, VA 22508-5726
Phone: (540) 308-3357
Approximate (ZIP-level) locationGet directions
Mailing address
2607 Lakeview Pkwy
Locust Grove, VA 22508-5726
Registry dates
- Enumerated
- 2020-06-04
- Last updated
- 2020-06-04
- Certified
- 2020-06-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.