Individual
MR. MAKOTO BRANDON IWASAKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT
Contact information
Practice address
6355 WALKER LN, SUITE 204, ALEXANDRIA, VA 22310-3245
(703) 921-2167
(703) 921-1789
Mailing address
115 E NELSON AVE, ALEXANDRIA, VA 22301-2035
(951) 990-5318
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
2305204802
VA
Other
Enumeration date
10/19/2006
Last updated
07/08/2007
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