Healthcare Provider Details

I. General information

NPI: 1154756682
Provider Name (Legal Business Name): REBECCA K TROSCH DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2013
Last Update Date: 10/13/2021
Certification Date: 10/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6225 BRANDON AVE STE 130
SPRINGFIELD VA
22150-2519
US

IV. Provider business mailing address

6225 BRANDON AVE STE 130
SPRINGFIELD VA
22150-2519
US

V. Phone/Fax

Practice location:
  • Phone: 703-569-7500
  • Fax: 703-855-0518
Mailing address:
  • Phone: 703-569-7500
  • Fax: 703-855-0518

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License NumberPTT28619
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License NumberPT26379
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305212969
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: