Individual
MISS JESSICA MARIE HEIDEBRINK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
30 CATOCTIN CIR SE STE 112, LEESBURG, VA 20175-3614
(571) 918-0197
(833) 217-6918
Mailing address
PO BOX 1769, MIDDLEBURG, VA 20118-1769
(571) 918-0197
(571) 918-4253
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
13544
TN
225100000X
Physical Therapist
Primary
2305214522
VA
225100000X
Physical Therapist
PENDING
VA
Other
Enumeration date
07/20/2021
Last updated
07/27/2021
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