Provider Demographics
NPI:1770861213
Name:LOEWER, JENNA SIRACUSE (DPT)
Entity Type:Individual
Prefix:MS
First Name:JENNA
Middle Name:SIRACUSE
Last Name:LOEWER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:14540 JOHN MARSHALL HWY STE 108
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20155-1693
Mailing Address - Country:US
Mailing Address - Phone:703-743-1020
Mailing Address - Fax:833-215-8081
Practice Address - Street 1:14540 JOHN MARSHALL HWY STE 108
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:VA
Practice Address - Zip Code:20155-1693
Practice Address - Country:US
Practice Address - Phone:703-743-1020
Practice Address - Fax:833-215-8081
Is Sole Proprietor?:No
Enumeration Date:2011-08-02
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033837-1225100000X
VA2305208291225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist