Provider Demographics
NPI:1801204060
Name:J2 THERAPY AND WELLNESS LLC
Entity Type:Organization
Organization Name:J2 THERAPY AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:NYREN
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:703-444-9562
Mailing Address - Street 1:46161 WESTLAKE DR
Mailing Address - Street 2:SUITE 330
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20165-5871
Mailing Address - Country:US
Mailing Address - Phone:703-444-9562
Mailing Address - Fax:703-430-2124
Practice Address - Street 1:46161 WESTLAKE DR
Practice Address - Street 2:SUITE 330
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20165-5871
Practice Address - Country:US
Practice Address - Phone:703-444-9562
Practice Address - Fax:703-430-2124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-31
Last Update Date:2016-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty