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General NPI Number Information
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NPI Number | 1912037367
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Entity Type | Individual
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Provider Name | ARVIN ILAGAN ILAGAN P.T.
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Gender | Male
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 01/02/2020
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Provider Practice Location Address
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Address Line | 9523 FALL HAVEN RD
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City | FREDERICKSBURG
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State | VA
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Zip | 22407
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Country | US
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Telephone | 540-260-5193
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Fax |
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Provider Business Mailing Address
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Address Line | 9523 FALL HAVEN RD
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City | FREDERICKSBURG
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State | VA
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Zip | 22407
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Country | US
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Telephone | 540-260-5193
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 40QA01442300
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License Number State | NJ
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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 | 0253261
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2305210205
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License Number State | VA
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