Organization
PHYSIOCORE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMIE BENNETT DPT (PHYSICAL THERAPIST)
(703) 399-5058
Entity
Organization
Contact information
Practice address
10268 LATNEY RD, FAIRFAX, VA 22032-3256
(703) 399-5058
Mailing address
10268 LATNEY RD, FAIRFAX, VA 22032-3256
(703) 399-5058
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
08/25/2020
Last updated
08/25/2020
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