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Individual

MRS. JENNIFER MARIE PASSINO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSPT

Contact information

Practice address
10525 WEST DR, FAIRFAX, VA 22030-4230
(703) 934-9411
(703) 934-9497
Mailing address
12552 SWEET LEAF TERRACE, FAIRFAX, VA 22033-2462
(703) 385-3910

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305203253
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
G02052
MEDICARE GROUP PIN
DC
Enumeration date
04/18/2006
Last updated
10/05/2007
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