Individual provider · Type 1 NPI

Jackalyn Nicole Peterson, DPT

Specialist · Fairfax, VA

NPI number 1013241769 Active

Practice location

9860 Fairfax Blvd, Suite 1
Fairfax, VA 22030-1737

Call (703) 383-1616 Map

Fax (703) 383-1166

Specialties and licenses

TaxonomyCodeLicense
Specialist Primary 174400000X2305206191 (VA)

Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

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About NPI 1013241769

Jackalyn Nicole Peterson, DPT's National Provider Identifier is 1013241769, issued on Sep 29, 2009. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Fairfax, VA. The record was last updated on Nov 14, 2016.