Healthcare Provider Details

I. General information

NPI: 1033097670
Provider Name (Legal Business Name): JAZLEEN VIRK DPT, PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 CATOCTIN CIR SE STE 112
LEESBURG VA
20175-3614
US

IV. Provider business mailing address

19289 CREEK FIELD CIR
LEESBURG VA
20176-1618
US

V. Phone/Fax

Practice location:
  • Phone: 571-918-0197
  • Fax: 571-918-4253
Mailing address:
  • Phone: 805-328-8717
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305217355
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: