Kinetic Balance

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

2305204182 Issued in VA

Legal business name

KINETIC BALANCE

Practice address

39149 Fry Farm Rd
Lovettsville, VA 20180

Phone

(703) 994-4834

Fax

(703) 649-6049

NPI assigned

Nov 23, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Catherine Wycoff, PT

Title

Owner

Phone

(703) 994-4834

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1258934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531440000000",
    "number": "1700114147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39149 FRY FARM RD",
            "city": "LOVETTSVILLE",
            "state": "VA",
            "postal_code": "201802749",
            "telephone_number": "703-994-4834",
            "fax_number": "703-649-6049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39149 FRY FARM RD",
            "city": "LOVETTSVILLE",
            "state": "VA",
            "postal_code": "20180",
            "telephone_number": "703-994-4834",
            "fax_number": "703-649-6049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINETIC BALANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-23",
        "last_updated": "2018-07-13",
        "status": "A",
        "authorized_official_last_name": "WYCOFF",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "703-994-4834",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "VA",
            "license": "2305204182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Clinic/Center in Lovettsville, VA
• Providers in Lovettsville, VA by specialty
• Physical Therapy Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.