Imari Jeanine Heavens
Physical Therapist - Orthopedic
12731 Marblestone Dr Ste 202
Woodbridge
, Virginia 22192-8334
Imari Jeanine Heavens
Physical Therapist - Orthopedic
12731 Marblestone Dr Ste 202
Woodbridge
, Virginia 22192-8334
(571) 659-2612
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About
Features
Specialties
- Physical Therapist - Orthopedic
Languages spoken
- English
Location
First Address
- Imari Jeanine Heavens
- 12731 Marblestone Dr Ste 202
- Woodbridge, VA
- Zip : 22192-8334
- Phone : (571) 659-2612
Second Address
- Imari Jeanine Heavens
- 12731 Marblestone Dr Ste 202
- Woodbridge, VA
- Zip : 22192-8334
- Phone : (571) 659-2612
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2251X0800X | Physical Therapist - Orthopedic |
National Provider Identifier
| NPI | 1043987795 |
|---|---|
| Provider Name | Imari Jeanine Heavens |
| First Address | Woodbridge, VA 22192-8334 |
| Second Address | Woodbridge, VA 22192-8334 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 30/08/2021 |
| Last Update Date | 30/08/2021 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.