JORDAN TANAVAGE

RESTON, VA
NPI1154190767
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy225100000X Physical Therapist
(Licence: DC  CP039578T)
Additional Taxonomies225100000X Physical Therapist
(Licence: VA  2305215372)
225100000X Physical Therapist
(Licence: MD  30263)
Enumeration Date2023-12-22
Last Update Date2025-01-24
Business Address
JORDAN TANAVAGE PT, DPT
2222 COLTS NECK RD
RESTON, VA 20191-2843
Phone number: 703-429-1130
Mailing Address
JORDAN TANAVAGE PT, DPT
PO BOX 296
CHAPTICO, MD 20621-0296
Phone number: 240-577-8351