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Individual

JONATHAN PHUONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
12825 MINNIEVILLE RD STE 201, LAKE RIDGE, VA 22192-3602
(703) 647-3130
Mailing address
6654 ROCK ISLAND RD APT 100, SPRINGFIELD, VA 22150-1974

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306605924
VA

Other

Enumeration date
01/04/2024
Last updated
01/04/2024
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