Individual
JONATHAN MOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTD
Contact information
Practice address
8270 WILLOW OAKS CORPORATE DR FL 2, FAIRFAX, VA 22031-4530
(000) 000-0000
Mailing address
8270 WILLOW OAKS CORPORATE DR FL 2, FAIRFAX, VA 22031-4530
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119009194
VA
Other
Enumeration date
10/01/2021
Last updated
10/01/2021
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