Provider Demographics
NPI:1134191000
Name:REMSEN, JODI MARIE (PT)
Entity type:Individual
Prefix:
First Name:JODI
Middle Name:MARIE
Last Name:REMSEN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14658 GAP WAY # 727
Mailing Address - Street 2:
Mailing Address - City:HAYMARKET
Mailing Address - State:VA
Mailing Address - Zip Code:20169-4958
Mailing Address - Country:US
Mailing Address - Phone:703-794-5570
Mailing Address - Fax:
Practice Address - Street 1:14265 LADDERBACKED DR
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:VA
Practice Address - Zip Code:20155-5922
Practice Address - Country:US
Practice Address - Phone:703-794-5570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305204539225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist