Individual
JEVENE MARIE SUMMERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSPT
Contact information
Practice address
3260 WILSON BLVD STE 21E, ARLINGTON, VA 22201-4423
(703) 963-5695
Mailing address
6320 9TH ST NW, WASHINGTON, DC 20011-1115
(703) 328-7076
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305202400
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2305202400
VIRGINIA STATE BOARD PHYSICAL THERAPY LICENSE
VA
Enumeration date
11/19/2008
Last updated
03/09/2018
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