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General NPI Number Information
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NPI Number | 1679366884
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Entity Type | Individual
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Provider Name | AMY ELIZABETH HERRON DPT
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Gender | Female
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Dates
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Enumeration Date | 05/28/2025
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Last Update Date | 05/28/2025
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Provider Practice Location Address
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Address Line | 700 W BROAD ST
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City | FALLS CHURCH
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State | VA
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Zip | 22046-3219
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Country | US
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Telephone | 703-992-9868
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Fax |
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Provider Business Mailing Address
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Address Line | 7232 WICKFORD DR
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City | ALEXANDRIA
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State | VA
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Zip | 22315-4213
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Country | US
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Telephone | 703-795-1719
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2305217161
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License Number State | VA
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