Provider Demographics
NPI:1972677714
Name:STORER, CARRIE ANN (DPT, OCS)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:ANN
Last Name:STORER
Suffix:
Gender:F
Credentials:DPT, OCS
Other - Prefix:
Other - First Name:CARRIE
Other - Middle Name:ANN
Other - Last Name:SCHNEIDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:9116 SILVER POINTE WAY
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX STATION
Mailing Address - State:VA
Mailing Address - Zip Code:22039-3071
Mailing Address - Country:US
Mailing Address - Phone:703-655-4506
Mailing Address - Fax:
Practice Address - Street 1:9116 SILVER POINTE WAY
Practice Address - Street 2:
Practice Address - City:FAIRFAX STATION
Practice Address - State:VA
Practice Address - Zip Code:22039-3071
Practice Address - Country:US
Practice Address - Phone:703-655-4506
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305202998225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist