Provider Demographics
NPI:1477008795
Name:GALUPE, SALLY (PT)
Entity Type:Individual
Prefix:
First Name:SALLY
Middle Name:
Last Name:GALUPE
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 1:2576 PASSIONFLOWER CT
Mailing Address - Street 2:
Mailing Address - City:DUMFRIES
Mailing Address - State:VA
Mailing Address - Zip Code:22026-3055
Mailing Address - Country:US
Mailing Address - Phone:571-275-1419
Mailing Address - Fax:
Practice Address - Street 1:2576 PASSIONFLOWER CT
Practice Address - Street 2:
Practice Address - City:DUMFRIES
Practice Address - State:VA
Practice Address - Zip Code:22026-3055
Practice Address - Country:US
Practice Address - Phone:571-275-1419
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-16
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305210552225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist