Individual
BENJAMIN FUENTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
13060 WORTH AVE, WOODBRIDGE, VA 22192-4120
(703) 988-3381
Mailing address
501 FAIRMOUNT AVE, SUITE 302, TOWSON, MD 21286-5457
(410) 927-8768
(410) 648-4878
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305210499
VA
Other
Enumeration date
08/04/2016
Last updated
08/04/2016
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