MEDICARE: MRS. JENNIFER W HERRINGTON DPT,OCS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2251X0800X	Orthopedic Physical Therapist	2305006600	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2305006600	OTHER	VA	VA LICENSE

General Provider Information

NPI Number	:	1043281652
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JENNIFER W HERRINGTON DPT,OCS

Provider Business Mailing Address
First Line	:	8400 RADFORD AVE STE 100
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22309-2585
Country	:	US
Telephone Number	:	571-481-4547
Fax Number	:	571-551-6419

Provider Business Practice Location Address
First Line	:	8400 RADFORD AVE STE 100
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22309
Country	:	US
Telephone Number	:	571-481-4547
Fax Number	:	571-551-6419

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/31/2006
Last Update Date	:	07/01/2019

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