Sam, Socheathdara

Sam, Socheathdara is an individual health care provider with primary practice located at 4040 Fairfax Dr Ste 120 , Arlington VA 22203-1613. He recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant, Student, Health Care / Student in an Organized Health Care Education/Training Program. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant is his primary health care specialty. Sam, Socheathdara can be contacted via phone (571) 777-0918.

Contact Information

Primary practice address
4040 Fairfax Dr Ste 120 Arlington VA 22203-1613
Phone: (571) 777-0918
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant 225200000X 2306606194 Virginia
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X

Profile Details

NPI number 1063166692
LBN Legal business name Sam, Socheathdara
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 11th, 2022
Last updated Dec 27th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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