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General NPI Number Information
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NPI Number | 1609897438
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Entity Type | Individual
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Provider Name | JENNIFER STARMANN OTT MPT
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Gender | Female
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Dates
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Enumeration Date | 07/21/2006
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Last Update Date | 02/06/2013
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Provider Practice Location Address
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Address Line | 3620 JOSEPH SIEWICK DR STE 100A
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City | FAIRFAX
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State | VA
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Zip | 22033-1756
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Country | US
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Telephone | 703-810-5227
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Fax | 703-810-5224
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Provider Business Mailing Address
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Address Line | 11240 WAPLES MILL RD STE 403
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City | FAIRFAX
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State | VA
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Zip | 22030
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Country | US
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Telephone | 703-395-4707
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Fax | 703-691-4933
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2305202587
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License Number State | VA
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