Provider Demographics
NPI:1740208453
Name:ALLMON, JENNIFER JOY (MSPT)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:JOY
Last Name:ALLMON
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11240 WAPLES MILL ROAD
Mailing Address - Street 2:SUITE 403
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030
Mailing Address - Country:US
Mailing Address - Phone:703-385-4707
Mailing Address - Fax:703-691-4933
Practice Address - Street 1:1850 TOWN CENTER PKWY
Practice Address - Street 2:STE. 403
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-3219
Practice Address - Country:US
Practice Address - Phone:703-810-5203
Practice Address - Fax:703-736-1677
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305202276225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA014148C95Medicare ID - Type Unspecified