Provider Demographics
NPI:1003909490
Name:HUSTON, PATRICIA SALIN (MSPT)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:SALIN
Last Name:HUSTON
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:PAT
Other - Middle Name:SALIN
Other - Last Name:HUSTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSPT
Mailing Address - Street 1:1110 ROSE HILL DR
Mailing Address - Street 2:STE 101
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903-5159
Mailing Address - Country:US
Mailing Address - Phone:434-979-5559
Mailing Address - Fax:434-979-0747
Practice Address - Street 1:1110 ROSE HILL DR
Practice Address - Street 2:STE 101
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22903-5159
Practice Address - Country:US
Practice Address - Phone:434-979-5559
Practice Address - Fax:434-979-0747
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-30
Last Update Date:2015-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305005458225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA06X423P01Medicare PIN