Individual
MARISSA G TIBBETTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
1850 TOWN CENTER PKWY STE 403, RESTON, VA 20190-3300
(703) 810-5203
(703) 810-5408
Mailing address
PO BOX 715868, PHILADELPHIA, PA 19171-5868
(804) 915-1910
(804) 968-1803
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305216687
VA
Other
Enumeration date
08/15/2024
Last updated
12/31/2024
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