Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Socheathdara Sam

Individual provider Physical Therapy Assistant · NPI 1063166692

Socheathdara Sam is a Physical Therapy Assistant in Arlington, Virginia. Works from 2 locations. Licensed in Virginia.

Licensed in
VA
In the registry since
2022
Specialties on file
2
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Practice location Address checks out

4040 Fairfax Dr Ste 120
Arlington, VA 22203-1613
Phone: (571) 777-0918
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 6355 Walker Ln Ste 512, Alexandria, VA 22310-3251 — (635) 551-2223

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence 2306606194 (VA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1063166692
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedFebruary 11, 2022
Last updated in NPPESDecember 27, 2023
Certification dateDecember 27, 2023
Mailing address3544 Gallows Rd, Annandale, VA 22003-1450

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