Mary Debolt, DPT
Physical Therapist in Alexandria, VA. Individual provider (NPI-1).
NPI number1649010331
StatusActive
Last updated in NPPESSep 16, 2024
Details
- NPI
- 1649010331
- Entity type
- Individual (NPI-1)
- Name
- Mary Debolt
- Credential
- DPT
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- May 29, 2024
- Certification date
- Sep 16, 2024
- Last updated
- Sep 16, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | 2305216481 | VA | Yes |
Practice location
6408 Grovedale Drive, Suite 102Alexandria, VA 22310-2596
Phone 703-884-8490
Mailing address
224-D Cornwall Street, Nw, Suite 403Leesburg, VA 20176-2704
Phone 703-737-6010
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