Organization
PRINCE WILLIAM PHYSICAL THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT W BREEN (MEMBER/OWNER)
(703) 368-4040
Entity
Organization
Contact information
Practice address
8565 SUDLEY RD STE A, MANASSAS, VA 20110-3864
(703) 368-4040
(703) 361-1177
Mailing address
12613 VICTORY LAKES LOOP, BRISTOW, VA 20136-1274
(703) 361-7940
(703) 361-1177
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
2305004656
VA
Other
Enumeration date
07/08/2010
Last updated
07/08/2010
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