Individual
FAUNICE REBECCA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT, P.T.
Contact information
Practice address
1625 N GEORGE MASON DR, ARLINGTON, VA 22205-3683
(703) 558-6507
Mailing address
1709 TARRYTOWN AVE, CROFTON, MD 21114-2515
(703) 336-2762
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305211720
VA
225100000X
Physical Therapist
25603
MD
225100000X
Physical Therapist
PT872732
DC
Other
Enumeration date
08/06/2015
Last updated
04/12/2022
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