Individual
MRS. MARYLOUISE CALABRESE GANSSLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
9901 SHADY COVE DR, FAIRFAX STATION, VA 22039-2962
(703) 764-9545
(703) 764-3806
Mailing address
9901 SHADY COVE DR, FAIRFAX STATION, VA 22039-2962
(703) 764-9545
(703) 764-3806
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305001734
VA
Other
Enumeration date
06/25/2007
Last updated
07/08/2007
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