Provider Demographics
NPI:1609945260
Name:GONZALEZ, JOY ANN (MPT, CWS)
Entity type:Individual
Prefix:MS
First Name:JOY
Middle Name:ANN
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:MPT, CWS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5500 SWAN ROAD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23188-6320
Mailing Address - Country:US
Mailing Address - Phone:210-535-2212
Mailing Address - Fax:
Practice Address - Street 1:3900 WINDSOR MEADE DRIVE
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188
Practice Address - Country:US
Practice Address - Phone:757-229-2808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2011-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305203078225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist