Individual
BRANDON WENGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
4229 LAFAYETTE CENTER DR STE 1250, CHANTILLY, VA 20151-1266
(703) 263-2020
Mailing address
4229 LAFAYETTE CENTER DR STE 1250, CHANTILLY, VA 20151-1266
(703) 263-2020
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305212295
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2305212295
LICENSE
VA
Enumeration date
08/21/2018
Last updated
10/02/2024
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