Search › Virginia › 2255A2300X
Jessica Shanks, ATC, VATL
NPI 1942617691 · on the registry since 2014 · sole proprietor
Practice
- Address
- 15721 Forest Park Dr
Forest Park High School
Woodbridge, VA 22193 - Phone
- (703) 583-3200
- Fax
- (703) 583-6867
- Clinicians at this address
- 2
Registry record
- Primary taxonomy
- 2255A2300X
2255A2300X
- Licence states on file
- VA
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2014-07-15
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Virginia