Provider Demographics
NPI:1346581964
Name:FURST, DENISE RICHMOND (LPTA)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:RICHMOND
Last Name:FURST
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8509 FOREST ST
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-3623
Mailing Address - Country:US
Mailing Address - Phone:703-609-2109
Mailing Address - Fax:
Practice Address - Street 1:8509 FOREST ST
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-3623
Practice Address - Country:US
Practice Address - Phone:703-609-2109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-06
Last Update Date:2013-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2306000548225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant