Provider Demographics
NPI:1417265695
Name:EPP, JANET WALKER
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:WALKER
Last Name:EPP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 CAMERON GLEN DR
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190-3308
Mailing Address - Country:US
Mailing Address - Phone:703-834-5950
Mailing Address - Fax:703-834-5843
Practice Address - Street 1:1800 CAMERON GLEN DR
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-3308
Practice Address - Country:US
Practice Address - Phone:703-834-5950
Practice Address - Fax:703-834-5843
Is Sole Proprietor?:No
Enumeration Date:2010-09-21
Last Update Date:2010-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305001195225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist