Provider Demographics
NPI:1700096526
Name:LOY, THEOLYN (PT)
Entity Type:Individual
Prefix:MS
First Name:THEOLYN
Middle Name:
Last Name:LOY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:LYN
Other - Middle Name:
Other - Last Name:LOY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:45965 NOKES BLVD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20166-6552
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:45965 NOKES BLVD
Practice Address - Street 2:SUITE 120
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20166-6552
Practice Address - Country:US
Practice Address - Phone:703-444-1798
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305001927225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist