Individual
BRENDA SALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10923 RAVENWOOD DR, MANASSAS, VA 20111-4304
(703) 732-3308
Mailing address
10923 RAVENWOOD DR, MANASSAS, VA 20111-4304
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306602777
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
225200000X
HOME HEALTH
VA
Enumeration date
02/11/2013
Last updated
02/11/2013
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