Provider Demographics
NPI:1528639721
Name:SANTOS, ROGELIO N JR (PT)
Entity type:Individual
Prefix:
First Name:ROGELIO
Middle Name:N
Last Name:SANTOS
Suffix:JR
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 LITTLE FALLS ST STE 410A
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22046-3393
Mailing Address - Country:US
Mailing Address - Phone:703-269-2238
Mailing Address - Fax:703-940-8999
Practice Address - Street 1:200 LITTLE FALLS ST STE 410A
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-3393
Practice Address - Country:US
Practice Address - Phone:703-269-2238
Practice Address - Fax:703-940-8999
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-08
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305205552225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty