Provider Demographics
NPI:1225171556
Name:JAVIER, LIZZY BEATRICE (PT)
Entity Type:Individual
Prefix:
First Name:LIZZY
Middle Name:BEATRICE
Last Name:JAVIER
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 1:3914 CENTREVILLE RD
Mailing Address - Street 2:SUITE 240
Mailing Address - City:CHANTILLY
Mailing Address - State:VA
Mailing Address - Zip Code:20151-3289
Mailing Address - Country:US
Mailing Address - Phone:703-689-2251
Mailing Address - Fax:703-689-2254
Practice Address - Street 1:3914 CENTREVILLE RD
Practice Address - Street 2:SUITE 240
Practice Address - City:CHANTILLY
Practice Address - State:VA
Practice Address - Zip Code:20151-3289
Practice Address - Country:US
Practice Address - Phone:703-689-2251
Practice Address - Fax:703-689-2254
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2013-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305-005620225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist