Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 2305207920 | VA |
NPI | 1083002711 |
---|---|
Provider Name | Dr. Michelle Thanh Cao |
First Address | Alexandria, VA 22311-5769 |
Second Address | Alexandria, VA 22311-5769 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/01/2015 |
Last Update Date | 05/01/2015 |