Healthcare Provider Details

I. General information

NPI: 1063992980
Provider Name (Legal Business Name): JESSICA BARCZI ZORN PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2018
Last Update Date: 08/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11350 RANDOM HILLS RD STE 885
FAIRFAX VA
22030-6044
US

IV. Provider business mailing address

3920 12TH ST S
ARLINGTON VA
22204-4204
US

V. Phone/Fax

Practice location:
  • Phone: 703-342-4690
  • Fax:
Mailing address:
  • Phone: 701-720-1074
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number2305212082
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: