Individual
IMARI JEANINE HEAVENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT,DPT
Contact information
Practice address
12731 MARBLESTONE DR STE 202, WOODBRIDGE, VA 22192-8334
(571) 659-2612
Mailing address
12731 MARBLESTONE DR STE 202, WOODBRIDGE, VA 22192-8334
(571) 659-2612
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
—
—
Other
Enumeration date
08/30/2021
Last updated
08/30/2021
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