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JEWELS ALYSSA TAVERA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
8550 LEE HWY STE 450, FAIRFAX, VA 22031-1519
(703) 208-1002
(703) 208-1127
Mailing address
1610 N AVENUE 55, LOS ANGELES, CA 90042-1107
(213) 453-3273

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305215610
VA
225100000X
Physical Therapist
303708
CA
225100000X
Physical Therapist

Other

Enumeration date
03/14/2023
Last updated
05/04/2023
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