Provider Demographics
NPI:1255406278
Name:STRAIT, DONNA R (PT)
Entity type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:R
Last Name:STRAIT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2579 JOHN MILTON DR
Mailing Address - Street 2:SUITE 120
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20171-2563
Mailing Address - Country:US
Mailing Address - Phone:703-860-2346
Mailing Address - Fax:703-860-2348
Practice Address - Street 1:2579 JOHN MILTON DR
Practice Address - Street 2:SUITE 120
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20171-2563
Practice Address - Country:US
Practice Address - Phone:703-860-2346
Practice Address - Fax:703-860-2348
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA2305202824225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAG02082S01Medicare ID - Type UnspecifiedSTRAIT PHYSICAL THERAPY
VAG02082Medicare ID - Type UnspecifiedDONNA'S INDIVIDUAL NUMBER