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NPI 1003358169

NPI 1003358169 : MINKYEONG SON DPT : ANNANDALE, VA

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General NPI Number Information
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    NPI Number           |    1003358169
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    Entity Type          |    Individual 
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    Provider Name        |    MINKYEONG SON DPT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/07/2016
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    Last Update Date     |    03/30/2018
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Provider Practice Location Address
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    Address Line         |    7010 LITTLE RIVER TPKE STE 335 
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    City                 |    ANNANDALE
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    State                |    VA
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    Zip                  |    22003-3249
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    Country              |    US
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    Telephone            |    703-827-3488
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    Fax                  |    703-827-3499
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Provider Business Mailing Address
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    Address Line         |    7010 LITTLE RIVER TPKE STE 335 
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    City                 |    ANNANDALE
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    State                |    VA
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    Zip                  |    22003-3249
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    Country              |    US
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    Telephone            |    703-827-3488
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    Fax                  |    703-827-3499
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    2305211819
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    License Number State |    VA
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