Provider Demographics
NPI:1215790357
Name:LANSDALE, PATRICK A (DPT, PT)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:A
Last Name:LANSDALE
Suffix:
Gender:M
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1769
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20118-1769
Mailing Address - Country:US
Mailing Address - Phone:703-933-0038
Mailing Address - Fax:703-933-0199
Practice Address - Street 1:2800 S SHIRLINGTON RD STE 510
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22206-3605
Practice Address - Country:US
Practice Address - Phone:703-933-0038
Practice Address - Fax:703-933-0199
Is Sole Proprietor?:No
Enumeration Date:2024-02-01
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305216293225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist