Provider Demographics
NPI:1013251420
Name:LODOVICHETTI, ANN K (PT, DPT)
Entity type:Individual
Prefix:MRS
First Name:ANN
Middle Name:K
Last Name:LODOVICHETTI
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:MS
Other - First Name:ANN
Other - Middle Name:K
Other - Last Name:BOWMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:PO BOX 1769
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20118-1769
Mailing Address - Country:US
Mailing Address - Phone:571-370-3686
Mailing Address - Fax:
Practice Address - Street 1:24560 SOUTHPOINT DR STE 250
Practice Address - Street 2:
Practice Address - City:ALDIE
Practice Address - State:VA
Practice Address - Zip Code:20105-3504
Practice Address - Country:US
Practice Address - Phone:571-370-3686
Practice Address - Fax:571-370-3687
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-26
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT023095208100000X
VA2305207684225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation