Provider Demographics
NPI:1184049637
Name:LYNCH, NANCY (DPT)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:LYNCH
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21620 RIDGETOP CIR
Mailing Address - Street 2:SUITE 180
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20166-6565
Mailing Address - Country:US
Mailing Address - Phone:703-406-0296
Mailing Address - Fax:703-406-0188
Practice Address - Street 1:21620 RIDGETOP CIR
Practice Address - Street 2:SUITE 180
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20166-6565
Practice Address - Country:US
Practice Address - Phone:703-406-0296
Practice Address - Fax:703-406-0188
Is Sole Proprietor?:No
Enumeration Date:2014-02-20
Last Update Date:2014-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305204064225100000X, 2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics