Provider Demographics
NPI:1336755560
Name:FABIS, CAMILLE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:CAMILLE
Middle Name:
Last Name:FABIS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4247 VALS WAY
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:VA
Mailing Address - Zip Code:22025-1140
Mailing Address - Country:US
Mailing Address - Phone:703-244-8794
Mailing Address - Fax:
Practice Address - Street 1:4247 VALS WAY
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:VA
Practice Address - Zip Code:22025-1140
Practice Address - Country:US
Practice Address - Phone:703-244-8794
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-22
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist