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General NPI Number Information
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NPI Number | 1629239207
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Entity Type | Organization
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Legal Business Name | CORE HEALTH
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Dates
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Enumeration Date | 06/17/2008
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Last Update Date | 06/17/2008
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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 | OWNER
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Name | DR. JENNIFER WOODARD SMALL
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Credential | D.P.T.
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Telephone | 703-283-3311
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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 |
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License Number State |
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