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Individual

LISA CORDOVA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
14524 POTOMAC MILLS RD, WOODBRIDGE, VA 22192-6803
(703) 490-6726
Mailing address
12678 CATAWBA DR, WOODBRIDGE, VA 22192-6414

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3932
LICENSE#
VA
Enumeration date
05/10/2007
Last updated
07/08/2007
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