Individual
LEO ALPHONSUS SAN JOSE MALINAO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
501 CHURCH ST NE STE 105, VIENNA, VA 22180-4734
(703) 938-8585
Mailing address
6779 LANTANA DR, BRYANS ROAD, MD 20616-4238
(229) 366-0666
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305215947
VA
Other
Enumeration date
08/10/2023
Last updated
08/10/2023
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