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Individual

MS. JUSTINE MAE BAUTISTA

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
P.T.

Contact information

Practice address
2076 DANIEL STUART SQ, WOODBRIDGE, VA 22191-3315
(703) 492-6934
Mailing address
4042 PENDER RIDGE TERRACE, FAIRFAX, VA 22033

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305102956
VA

Other

Enumeration date
04/28/2006
Last updated
07/08/2007
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