Provider Demographics
NPI:1326408642
Name:NORTHERN VIRGINIA FOOT AND ANKLE ASSOCIATES
Entity Type:Organization
Organization Name:NORTHERN VIRGINIA FOOT AND ANKLE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:
Authorized Official - Last Name:DANSEY
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:571-213-1047
Mailing Address - Street 1:8221 OLD COURTHOUSE RD
Mailing Address - Street 2:STE 102
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-3839
Mailing Address - Country:US
Mailing Address - Phone:703-734-1311
Mailing Address - Fax:703-734-9090
Practice Address - Street 1:8221 OLD COURTHOUSE RD
Practice Address - Street 2:STE 102
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-3839
Practice Address - Country:US
Practice Address - Phone:703-734-1311
Practice Address - Fax:703-734-9090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-29
Last Update Date:2016-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305203384225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty