Provider Demographics
NPI:1912289539
Name:JOHN, SHERYL (MPT)
Entity type:Individual
Prefix:
First Name:SHERYL
Middle Name:
Last Name:JOHN
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2955 S GLEBE RD
Mailing Address - Street 2:SUITE E
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22206-2730
Mailing Address - Country:US
Mailing Address - Phone:703-535-8887
Mailing Address - Fax:703-535-7819
Practice Address - Street 1:18702 RED MAPLE CT
Practice Address - Street 2:
Practice Address - City:TRIANGLE
Practice Address - State:VA
Practice Address - Zip Code:22172-1511
Practice Address - Country:US
Practice Address - Phone:202-487-7156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-10
Last Update Date:2019-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305202520225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist