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Individual

MR. THOMAS RYAN SHORT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LPTA, LMT

Contact information

Practice address
1936 OPITZ BLVD STE A, WOODBRIDGE, VA 22191-3360
(540) 841-4443
Mailing address
4060 WESTWIND DR, WOODBRIDGE, VA 22193-5168
(703) 927-5395

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306605845
VA
225700000X
Massage Therapist
0019011669
VA

Other

Enumeration date
04/11/2021
Last updated
04/11/2021
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