Individual
SHANNON ELIZABETH TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
6501 LOISDALE CT, SPRINGFIELD, VA 22150-1826
(703) 922-1000
Mailing address
6501 LOISDALE CT, SPRINGFIELD, VA 22150-1826
(703) 922-1000
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306602368
VA
Other
Enumeration date
02/04/2008
Last updated
02/04/2008
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