Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | VA |
NPI | 1013685072 |
---|---|
Provider Name | Dr. Samantha L Sova |
First Address | Chantilly, VA 20151-3290 |
Second Address | Chantilly, VA 20151-3290 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/09/2021 |
Last Update Date | 02/09/2021 |