Individual
JASON MICHAEL OLIVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1860 TOWN CENTER DR, SUITE 300, RESTON, VA 20190-5896
(703) 483-4684
Mailing address
1860 TOWN CENTER DR, SUITE 300, RESTON, VA 20190-5896
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306603190
VA
Other
Enumeration date
01/19/2012
Last updated
01/19/2012
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