MEDICARE: REBECCA K TROSCH DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2251P0200X	Pediatric Physical Therapist	PTT28619	FL
2	2251P0200X	Pediatric Physical Therapist	PT26379	FL
3	225100000X	Physical Therapist	2305212969	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154756682
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA K TROSCH DPT

Provider Business Mailing Address
First Line	:	6225 BRANDON AVE STE 130
Second Line	:
City	:	SPRINGFIELD
State	:	VA
Zip	:	22150-2519
Country	:	US
Telephone Number	:	703-569-7500
Fax Number	:	703-855-0518

Provider Business Practice Location Address
First Line	:	6225 BRANDON AVE STE 130
Second Line	:
City	:	SPRINGFIELD
State	:	VA
Zip	:	22150-2519
Country	:	US
Telephone Number	:	703-569-7500
Fax Number	:	703-855-0518

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/03/2013
Last Update Date	:	10/13/2021

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