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Individual

BIANCA BASS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
8320 OLD COURTHOUSE RD STE 410, VIENNA, VA 22182-3848
(703) 734-2889
Mailing address
8320 OLD COURTHOUSE RD STE 410, VIENNA, VA 22182-3848

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
21712
MD
225100000X
Physical Therapist
Primary
2305205028
VA
225100000X
Physical Therapist
PT870617
DC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
K949 - 0042
CAREFIRST
VA
01
K949 -0042
CAREFIRST
DC
Enumeration date
01/11/2006
Last updated
12/16/2019
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