Provider Demographics
NPI:1194603795
Name:DAVIS, DELANIE J (DPT, PT)
Entity type:Individual
Prefix:
First Name:DELANIE
Middle Name:J
Last Name:DAVIS
Suffix:
Gender:F
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:12701 FAIR LAKES CIR STE 102
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22033-4913
Mailing Address - Country:US
Mailing Address - Phone:571-918-0197
Mailing Address - Fax:571-918-4253
Practice Address - Street 1:30 CATOCTIN CIR SE STE 112
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20175-3614
Practice Address - Country:US
Practice Address - Phone:571-918-0197
Practice Address - Fax:571-918-4253
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-22
Last Update Date:2025-08-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MS8049225100000X
VACP048965T225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist