Individual
MRS. MARIA LOURDES SISON-WRIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2108 GALLOWS RD, SUITE A, VIENNA, VA 22182-3980
(703) 930-1338
(703) 763-2333
Mailing address
2108 GALLOWS RD, SUITE A, VIENNA, VA 22182-3980
(703) 930-1338
(703) 763-2333
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305004830
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
76820001
BLUECROSS BLUE SHIELD
VA
Enumeration date
03/21/2007
Last updated
10/24/2012
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