Provider Demographics
NPI:1174553242
Name:O'CONNOR, MICHAEL JAMES (PT MS, DPT)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:JAMES
Last Name:O'CONNOR
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Gender:M
Credentials:PT MS, DPT
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Mailing Address - Street 1:200 N GLEBE RD
Mailing Address - Street 2:SUITE 310
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22203-3728
Mailing Address - Country:US
Mailing Address - Phone:703-527-1700
Mailing Address - Fax:703-527-1507
Practice Address - Street 1:200 N GLEBE RD
Practice Address - Street 2:SUITE 310
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22203-3728
Practice Address - Country:US
Practice Address - Phone:703-527-1700
Practice Address - Fax:703-527-1507
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2012-09-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA23052020152251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA00A826P87Medicare ID - Type Unspecified