JASON TODD DERTING

FREDERICKSBURG, VA
NPI1669774147
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: VA  2306602034)
Enumeration Date2010-12-03
Last Update Date2010-12-03
Business Address
-- JASON TODD DERTING LPTA
140 BRIMLEY ROAD
FREDERICKSBURG, VA 22406
Phone number: 540-752-0111
Mailing Address
-- JASON TODD DERTING LPTA
6801 ORCHID LN
FREDERICKSBURG, VA 22407-8502
Phone number: 540-419-7410
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