Provider Demographics
NPI:1205849478
Name:ANDERSON, JANICE E (PT)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:E
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9384 FORESTWOOD LN
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-4747
Mailing Address - Country:US
Mailing Address - Phone:703-361-9677
Mailing Address - Fax:703-361-9678
Practice Address - Street 1:9384 FORESTWOOD LN
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-4747
Practice Address - Country:US
Practice Address - Phone:703-361-9677
Practice Address - Fax:703-361-9678
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2011-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305005343225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist