Individual
MRS. JENNIFER MAHLER GAMBOA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT, OCS
Contact information
Practice address
410 S MAPLE AVE STE 100, FALLS CHURCH, VA 22046-4246
(703) 988-6010
(703) 526-0430
Mailing address
408 HIGUERA ST STE 200, SAN LUIS OBISPO, CA 93401-6135
(805) 788-0805
(805) 788-0845
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
2305005274
VA
225100000X
Physical Therapist
PT2733
DC
2251X0800X
Orthopedic Physical Therapist
Primary
2305005274
VA
Other
Enumeration date
05/07/2007
Last updated
01/26/2024
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