Provider Demographics
NPI:1891804910
Name:ESTERSON, PERRY S (PT)
Entity Type:Individual
Prefix:MR
First Name:PERRY
Middle Name:S
Last Name:ESTERSON
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1257 WOODBROOK CT
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20194-1344
Mailing Address - Country:US
Mailing Address - Phone:703-787-6620
Mailing Address - Fax:
Practice Address - Street 1:6565 ARLINGTON BLVD
Practice Address - Street 2:220
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-3013
Practice Address - Country:US
Practice Address - Phone:703-942-8824
Practice Address - Fax:703-942-8834
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2009-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305001570225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist