Jennifer Branch, LPTA
Individual provider Active NPI Physical Therapy Assistant · Broadlands, VA
NPI 1194134932 · NPPES record last updated Aug 6, 2014
Key facts
- NPI
- 1194134932
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 2306603923 (VA)
- Practice address
- 21501 Thornhill PL
Broadlands, VA 20148-5068 - Phone
- (703) 244-6586
- NPI assigned
- Aug 6, 2014
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2306603923 | VA | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 2306603923 | VA | Yes |
Addresses
Primary practice location
21501 Thornhill PL
Broadlands, VA 20148-5068
Mailing address
21501 Thornhill PL
Broadlands, VA 20148-5068
Phone (703) 244-6586
Other providers in Broadlands, VA
- Jana Christensen Bennett
- Elizabeth Virginia Bergstrom
- Tamara Billingsley
- Michelle Black
- Victoria Boyles
- Megan Braxton
- Jodi Lynn Brill
- Broadlands Speech and Language P.C.
- Tara V. Brokaw
- Stacey Brosnan
All providers in Broadlands, VA · Physical Therapy Assistant in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 6, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.