Individual
MR. JASON M BRIDGES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, MSPT
Contact information
Practice address
10128 W BROAD ST BLDG III, GLEN ALLEN, VA 23060-6761
(804) 217-9210
(804) 217-9213
Mailing address
PO BOX 69030, BALTIMORE, MD 21264-9030
(757) 873-2302
(757) 873-2306
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305203424
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
192953
BCBS PHYSICAL THERAPY
VA
01
—
650025723
RAILROAD MEDICARE
VA
01
—
7914439
AETNA
VA
05
—
8953023
—
VA
Enumeration date
04/04/2006
Last updated
04/12/2018
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