Individual
JACQUELYN LOY CANADAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
6701 IRONBRIDGE PKWY, CHESTER, VA 23831-1469
(804) 318-3304
Mailing address
15466 FOXVALE WAY, MIDLOTHIAN, VA 23112-6535
(804) 921-9647
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306601276
VA
Other
Enumeration date
09/14/2022
Last updated
09/14/2022
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