Individual
JUDY JI HYE JO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13903 BARNSLEY PL, CENTREVILLE, VA 20120-5209
(703) 622-1243
Mailing address
13903 BARNSLEY PL, CENTREVILLE, VA 20120-5209
(703) 622-1243
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306606186
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
NONE
—
Enumeration date
10/13/2022
Last updated
10/13/2022
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