Individual
MS. CARMEN ANA CANCEL-DE JESUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1936-B OPITZ BLVD., WOODBRIDGE, VA 22191
(703) 490-1330
(703) 490-3991
Mailing address
3234 FOOTHILL ST, WOODBRIDGE, VA 22192-1405
(703) 497-0507
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
2251P0200X
Pediatric Physical Therapist
—
—
Other
Enumeration date
03/23/2007
Last updated
11/06/2009
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