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NPI Code Detail

MEDICARE: HEATHER RENEE STARBUCK

MEDICARE: HEATHER RENEE STARBUCK
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
1225XP0019XPhysical Rehabilitation Occupational Therapist0119003447VA

General Provider Information

NPI Number : 1891092714
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEATHER RENEE STARBUCK
Provider Business Mailing Address
First Line : 5646 GOVERNORS POND CIR
Second Line :
City : ALEXANDRIA
State : VA
Zip : 22310-2348
Country : US
Telephone Number : 804-307-9301
Fax Number :
Provider Business Practice Location Address
First Line : 2729 KING ST
Second Line :
City : ALEXANDRIA
State : VA
Zip : 22302-4008
Country : US
Telephone Number : 703-836-8838
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/14/2011
Last Update Date : 02/14/2011

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Directions to “ HEATHER RENEE STARBUCK ” Practice Location

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