Provider Demographics
NPI:1073633855
Name:HESS, LAWRENCE WILLIAM (MPT, ATC, CSCS)
Entity Type:Individual
Prefix:MR
First Name:LAWRENCE
Middle Name:WILLIAM
Last Name:HESS
Suffix:
Gender:M
Credentials:MPT, ATC, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20404 ELM GROVE TER
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-3711
Mailing Address - Country:US
Mailing Address - Phone:703-729-3997
Mailing Address - Fax:
Practice Address - Street 1:21300 REDSKIN PARK DR
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-6100
Practice Address - Country:US
Practice Address - Phone:703-726-7005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305203254225100000X
VA01260002992255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Not Answered2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer