| Doctor Name: | JEAN ELIZA WANG |
| NPI Number: | 1659392488 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MPT |
| License Number: | 2305203137 |
| Business Practice Address: | 3620 Joseph Siewick Dr Ste100a Fairfax, VA - 220331756 |
| Business Phone Number: | 7038105227 |
| Business Fax Number: | 7038105224 |
| Mailing Address: | 11240 Waples Mill Rd, Ste 403 FAIRFAX |
| State: | VA |
| Postal Code: | 22030 |
| Phone Number: | 7033854707 |
| Fax Number: | 7036914933 |
| NPI Enumeration Date: | 07/21/2006 |
| NPI Last Update Date: | 02/06/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 2305203137 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |