Basic Information
| Provider Information | |||||||||
| NPI: | 1801163670 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TOBEY | ||||||||
| FirstName: | JAMIESON | ||||||||
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| Credential: | LPTA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 43311 CHOKEBERRY SQ | ||||||||
| Address2: | |||||||||
| City: | ASHBURN | ||||||||
| State: | VA | ||||||||
| PostalCode: | 201474498 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7034721346 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1800 CAMERON GLEN DR | ||||||||
| Address2: | |||||||||
| City: | RESTON | ||||||||
| State: | VA | ||||||||
| PostalCode: | 201903308 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7038345800 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/22/2011 | ||||||||
| LastUpdateDate: | 11/22/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225200000X | 2306602801 | VA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant |
No ID Information.