Individual
HAYZQUEL COROMOTO HERNANDEZ CASANOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
7120 BRADDOCK RD, ANNANDALE, VA 22003-6007
(703) 256-9770
Mailing address
7908 JOHN ADAMS CT APT 102, ANNANDALE, VA 22003-6579
(804) 247-8131
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306605316
VA
Other
Enumeration date
12/15/2021
Last updated
12/15/2021
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