Provider Demographics
NPI:1235208109
Name:OCONNOR, ROBYN (MPT)
Entity Type:Individual
Prefix:
First Name:ROBYN
Middle Name:
Last Name:OCONNOR
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10710 MONTGOMERY DR
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20111-2805
Mailing Address - Country:US
Mailing Address - Phone:703-357-7436
Mailing Address - Fax:
Practice Address - Street 1:19441 GOLF VISTA PLAZA
Practice Address - Street 2:SUITE 230
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-8271
Practice Address - Country:US
Practice Address - Phone:703-724-7474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA2305203039OtherLICENSE#