Provider Demographics
NPI:1750765996
Name:ROPER, ARLENE (PTA)
Entity type:Individual
Prefix:MRS
First Name:ARLENE
Middle Name:
Last Name:ROPER
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 REDBORNE CT
Mailing Address - Street 2:APT 101
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23114-7012
Mailing Address - Country:US
Mailing Address - Phone:804-874-6611
Mailing Address - Fax:
Practice Address - Street 1:1700 REDBOURNE CT
Practice Address - Street 2:APT 101
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23114
Practice Address - Country:US
Practice Address - Phone:804-874-6611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-17
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2306604069225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant