Individual
JONATHAN EVAN COLLINSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CMT
Contact information
Practice address
7060 COLUMBIA PIKE, ANNANDALE, VA 22003-3104
(703) 916-8782
Mailing address
7060 COLUMBIA PIKE, ANNANDALE, VA 22003-3104
(703) 916-8782
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
0019009890
VA
Other
Enumeration date
08/02/2011
Last updated
08/02/2011
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