| Doctor Name: | MRS. STACEY L SURNEAR |
| NPI Number: | 1386927655 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS PT |
| License Number: | 011387 |
| Business Practice Address: | 3801 Fairfax Dr Ste 11 Arlington, VA - 222031762 |
| Business Phone Number: | 7035221060 |
| Business Fax Number: | |
| Mailing Address: | 14137 Autumn Cir, CENTREVILLE |
| State: | VA |
| Postal Code: | 201213856 |
| Phone Number: | 4408236286 |
| Fax Number: | |
| NPI Enumeration Date: | 09/23/2011 |
| NPI Last Update Date: | 10/31/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | 011387 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OH |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | 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. |