Provider Demographics
NPI:1750585410
Name:FALLON, BARBARA L (MSPT, DPT)
Entity type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:L
Last Name:FALLON
Suffix:
Gender:F
Credentials:MSPT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4635 KNIGHT PL
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22311-4923
Mailing Address - Country:US
Mailing Address - Phone:703-845-7947
Mailing Address - Fax:703-527-5624
Practice Address - Street 1:801 N QUINCY ST
Practice Address - Street 2:SUITE #130
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22203-1999
Practice Address - Country:US
Practice Address - Phone:703-527-5492
Practice Address - Fax:703-527-5624
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305202857225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA194317OtherANTHEM BCBS
DCG350-0001OtherCAREFIRST BCBS