Provider Demographics
NPI:1164774147
Name:ERRERA, LOIS CAPOZZOLI (PT)
Entity Type:Individual
Prefix:
First Name:LOIS
Middle Name:CAPOZZOLI
Last Name:ERRERA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3120 GRACEFIELD RD
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-5810
Mailing Address - Country:US
Mailing Address - Phone:301-572-8372
Mailing Address - Fax:301-572-8415
Practice Address - Street 1:3120 GRACEFIELD RD
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-5810
Practice Address - Country:US
Practice Address - Phone:301-572-8372
Practice Address - Fax:301-572-8415
Is Sole Proprietor?:No
Enumeration Date:2012-10-15
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD22152225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist