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Individual

MISS JUDITH ANN GRANDINETTI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPTA

Contact information

Practice address
6007 CREEKSTONE LN, CENTREVILLE, VA 20120-3408
(703) 628-9507
Mailing address
6007 CREEKSTONE LN, CENTREVILLE, VA 20120-3408
(703) 628-9507

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PTA 21540
FL

Other

Enumeration date
02/06/2009
Last updated
02/06/2009
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