Individual
MRS. STACEY L SURNEAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS PT
Contact information
Practice address
3801 FAIRFAX DR STE 11, ARLINGTON, VA 22203-1762
(703) 522-1060
Mailing address
14137 AUTUMN CIR, CENTREVILLE, VA 20121-3856
(440) 823-6286
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
011387
OH
174400000X
Specialist
Primary
2305207100
VA
Other
Enumeration date
09/23/2011
Last updated
10/31/2011
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