Provider Demographics
NPI:1447935069
Name:OCONER, FERNAN LANCE PASCO (DPT, RPT)
Entity type:Individual
Prefix:
First Name:FERNAN LANCE
Middle Name:PASCO
Last Name:OCONER
Suffix:
Gender:M
Credentials:DPT, RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6309 FARMVIEW CT
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-2600
Mailing Address - Country:US
Mailing Address - Phone:171-830-7924
Mailing Address - Fax:
Practice Address - Street 1:1131 WALKER RD
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:VA
Practice Address - Zip Code:22066-1816
Practice Address - Country:US
Practice Address - Phone:703-223-5226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-20
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD29288225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist