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General NPI Number Information
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NPI Number | 1053307553
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Entity Type | Individual
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Provider Name | TEONETTE O VELASCO DPT
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Gender | Female
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Dates
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Enumeration Date | 09/21/2005
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Last Update Date | 06/05/2025
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Provider Practice Location Address
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Address Line | 3700 FETTLER PARK DR
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City | DUMFRIES
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State | VA
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Zip | 22025-2050
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Country | US
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Telephone | 703-441-7658
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Fax | 703-441-7695
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Provider Business Mailing Address
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Address Line | 9300 DEWITT LOOP
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City | FORT BELVOIR
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State | VA
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Zip | 22060-5285
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Country | US
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Telephone |
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Fax |
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 2305204197
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2305204197
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License Number State | VA
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