Individual
MRS. JENNIFER ANNE LAUSTEN III
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
22 FAIRFAX ST SE, LEESBURG, VA 20175-3616
(703) 669-6100
(703) 669-6101
Mailing address
20817 MINTWOOD CT, ASHBURN, VA 20147-4003
(703) 723-1063
Taxonomy
Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
Primary
2305004038
VA
Other
Enumeration date
09/06/2005
Last updated
07/08/2007
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