Provider Demographics
NPI:1366466559
Name:MASTERS, JENNIFER CRISTIN (DPT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:CRISTIN
Last Name:MASTERS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:CRISTIN BOAST
Other - Last Name:RAMIREZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT, COMT, BCTMB
Mailing Address - Street 1:15401 MADISON RUN RD
Mailing Address - Street 2:
Mailing Address - City:GORDONSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22942-8723
Mailing Address - Country:US
Mailing Address - Phone:540-672-0233
Mailing Address - Fax:540-972-9516
Practice Address - Street 1:250 MERCHANT WALK AVE STE 300
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22902-6520
Practice Address - Country:US
Practice Address - Phone:434-328-4900
Practice Address - Fax:434-295-0420
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305202950225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist