Provider Demographics
NPI:1154756682
Name:TROSCH, REBECCA K (DPT)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:K
Last Name:TROSCH
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6225 BRANDON AVE STE 130
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22150-2519
Mailing Address - Country:US
Mailing Address - Phone:703-569-7500
Mailing Address - Fax:703-855-0518
Practice Address - Street 1:6225 BRANDON AVE STE 130
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22150-2519
Practice Address - Country:US
Practice Address - Phone:703-569-7500
Practice Address - Fax:703-855-0518
Is Sole Proprietor?:No
Enumeration Date:2013-09-03
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTT286192251P0200X
FLPT263792251P0200X
VA2305212969225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL010029500Medicaid