Individual
JACQUELINE LEE MAIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA, CLT
Contact information
Practice address
2652 W OX RD, HERNDON, VA 20171-3530
(703) 307-4204
Mailing address
2652 W OX RD, HERNDON, VA 20171-3530
(703) 307-4204
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306603322
VA
Other
Enumeration date
05/25/2013
Last updated
05/25/2013
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