Individual
MARIVIC OFILAS DE LEON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPT
Contact information
Practice address
1 GEDDY DR APT D, HAMPTON, VA 23669-3738
(765) 426-2670
Mailing address
1 GEDDY DR APT D, HAMPTON, VA 23669-3738
(765) 426-2670
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
05009461A
IN
225100000X
Physical Therapist
22117
MD
225100000X
Physical Therapist
Primary
2305205882
VA
Other
Enumeration date
04/22/2008
Last updated
07/18/2012
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