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Individual

TISA L NEWHOUSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
12191 CLIPPER DR, WOODBRIDGE, VA 22192-2237
(703) 496-3486
Mailing address
14123 WELLMAN CT, MANASSAS, VA 20112-7003
(703) 794-8220

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306001507
VA

Other

Enumeration date
05/11/2007
Last updated
07/08/2007
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