Individual
LAURA A MUNTZER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
44035 RIVERSIDE PKWY, #400, LEESBURG, VA 20176-8260
(703) 858-5421
(703) 858-9573
Mailing address
2901 TELESTAR CT STE 300, FALLS CHURCH, VA 22042-1263
(703) 591-1688
(703) 591-1445
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110001703
VA
363AM0700X
Medical Physician Assistant
0110001703
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1184635450
—
VA
01
—
P01296922
RAILROAD MEDICARE PIN
VA
Enumeration date
08/11/2006
Last updated
08/27/2021
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