Individual
BAWNA NANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13306 GLEN TAYLOR LN, HERNDON, VA 20171-4047
(571) 839-9273
Mailing address
13306 GLEN TAYLOR LN, HERNDON, VA 20171-4047
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305208061
VA
Other
Enumeration date
09/30/2014
Last updated
09/30/2014
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