Individual
JEANNA KATHERINE MARCUSSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5535 S WILLIAMSON BLVD, # 774, PORT ORANGE, FL 32128-8311
(800) 330-7711
Mailing address
635 VILLAGE PKWY, FREDERICKSBURG, VA 22406-7297
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306602855
VA
Other
Enumeration date
01/20/2012
Last updated
01/20/2012
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