Healthcare Provider Details

I. General information

NPI: 1639355035
Provider Name (Legal Business Name): FRANCIS YLLANA RAMIREZ MS, PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/15/2008
Last Update Date: 09/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13854 SMOKETOWN RD
WOODBRIDGE VA
22192-4210
US

IV. Provider business mailing address

5252 LYNGATE CT STE 203
BURKE VA
22015-1672
US

V. Phone/Fax

Practice location:
  • Phone: 703-670-9935
  • Fax: 703-670-9939
Mailing address:
  • Phone: 703-239-2300
  • Fax: 703-239-2301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number870833
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number870833
License Number StateDC
# 3
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number870833
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: