Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 2305214087 | VA |
NPI | 1023693157 |
---|---|
Provider Name | Marisa Jo Erskine |
First Address | Vienna, VA 22182-5113 |
Second Address | Annandale, VA 22003-4632 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/03/2021 |
Last Update Date | 10/03/2021 |