Provider Demographics
NPI:1013432863
Name:SORANO, JESSICA RUTH (DPT)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:RUTH
Last Name:SORANO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
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Mailing Address - Street 1:9247 LAUREL RIDGE CROSSING RD
Mailing Address - Street 2:
Mailing Address - City:LORTON
Mailing Address - State:VA
Mailing Address - Zip Code:22079-2959
Mailing Address - Country:US
Mailing Address - Phone:912-660-5972
Mailing Address - Fax:
Practice Address - Street 1:3299 WOODBURN RD STE 310
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-7300
Practice Address - Country:US
Practice Address - Phone:703-849-8142
Practice Address - Fax:703-849-0735
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-12
Last Update Date:2017-08-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA2305211429225100000X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic