Jonathan Evan Collinsworth, CMT
Massage Therapist in Annandale, VA. Individual provider (NPI-1).
NPI number1720366263
StatusActive
Last updated in NPPESAug 2, 2011
Details
- NPI
- 1720366263
- Entity type
- Individual (NPI-1)
- Name
- Jonathan Evan Collinsworth
- Credential
- CMT
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 2, 2011
- Last updated
- Aug 2, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225700000X | Massage Therapist | 0019009890 | VA | Yes |
Practice location
7060 Columbia PikeAnnandale, VA 22003-3104
Phone 703-916-8782
Mailing address
7060 Columbia PikeAnnandale, VA 22003-3104
Phone 703-916-8782
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