Individual
PONNI JEEVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
21281 ARCADIA CT, ASHBURN, VA 20147-4876
(703) 774-6158
Mailing address
21281 ARCADIA CT, ASHBURN, VA 20147-4876
(703) 774-6158
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
0019019302
VA
Other
Enumeration date
04/16/2024
Last updated
04/16/2024
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