Basic Information
Provider Information
NPI: 1811102429
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RAY
FirstName: SHILPA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MPT
OtherOrganizationName:  
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Mailing Information
Address1: PO BOX 1769
Address2:  
City: MIDDLEBURG
State: VA
PostalCode: 201181769
CountryCode: US
TelephoneNumber: 5406878181
FaxNumber: 5406878256
Practice Location
Address1: 6355 WALKER LANE
Address2: SUITE 507
City: ALEXANDRIA
State: VA
PostalCode: 22310
CountryCode: US
TelephoneNumber: 7038220039
FaxNumber: 7038220211
Other Information
ProviderEnumerationDate: 05/14/2007
LastUpdateDate: 04/02/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X2305204852VAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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