Provider Demographics
NPI:1609002351
Name:DAUCH, MARY A F (PT, DPT, OCS)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:A F
Last Name:DAUCH
Suffix:
Gender:F
Credentials:PT, DPT, OCS
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:ANGELA
Other - Last Name:FEINDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:350 NEW FIDELITY CT
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-2665
Mailing Address - Country:US
Mailing Address - Phone:919-258-2714
Mailing Address - Fax:410-648-4878
Practice Address - Street 1:10518 SPOTSYLVANIA AVE STE 100
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22408-2693
Practice Address - Country:US
Practice Address - Phone:540-710-5341
Practice Address - Fax:540-710-5372
Is Sole Proprietor?:No
Enumeration Date:2009-06-09
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305206091225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC05954OtherGROUP MEDICARE PTAN