Healthcare Provider Details

I. General information

NPI: 1740333228
Provider Name (Legal Business Name): SCOTT JAMES LORAH P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 05/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 N WASHINGTON ST
FALLS CHURCH VA
22046-4518
US

IV. Provider business mailing address

2101 E JEFFERSON ST KAISER PERMANENETE ATTN: SANJAY MATHUR DATA MGMT DEPT
ROCKVILLE MD
20852-4908
US

V. Phone/Fax

Practice location:
  • Phone: 703-237-4000
  • Fax: 703-922-1043
Mailing address:
  • Phone: 301-816-7446
  • Fax: 301-816-7170

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305202981
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: