Individual
ERIN E. JASENAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
6970 FOX HUNT LN, GLOUCESTER, VA 23061-5394
(804) 694-8111
(804) 694-5574
Mailing address
771 PILOT HOUSE DR, SUITE A, NEWPORT NEWS, VA 23606-1990
(757) 873-2302
(757) 873-2306
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305207632
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1821348426
—
VA
01
—
C05954
GROUP MEDICARE PTAN
VA
01
—
P01127681
MEDICARE RAILROAD
VA
Enumeration date
09/12/2012
Last updated
02/12/2013
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