Individual
MR. JOHN BULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPTA
Contact information
Practice address
6506 BEVERLY AVE, MC LEAN, VA 22101-5220
(202) 236-7535
Mailing address
6506 BEVERLY AVE, MC LEAN, VA 22101-5220
(202) 236-7535
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306604175
VA
Other
Enumeration date
07/16/2015
Last updated
07/16/2015
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