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General NPI Number Information
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NPI Number | 1609045525
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Entity Type | Individual
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Provider Name | JENNIFER WOODARD SMALL D.P.T., WCS, OCS
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Gender | Female
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Dates
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Enumeration Date | 02/25/2008
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Last Update Date | 08/20/2012
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Provider Practice Location Address
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Address Line | 20098 ASHBROOK PL SUITE 190
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City | ASHBURN
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State | VA
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Zip | 20147-3393
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Country | US
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Telephone | 703-283-3311
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Fax |
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Provider Business Mailing Address
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Address Line | 19309 WINMEADE DR NUMBER 111
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City | LANSDOWNE
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State | VA
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Zip | 20176-6507
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Country | US
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Telephone | 703-283-3311
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 2305005672
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License Number State | VA
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