Individual
MR. JUDE WARNER LASERNA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
8605 CENTREVILLE RD, MANASSAS, VA 20110-5265
(703) 257-6258
Mailing address
14006 GUNNERS PL, CENTREVILLE, VA 20121-3536
(804) 931-0245
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
2305207587
VA
Other
Enumeration date
11/24/2015
Last updated
11/24/2015
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