Individual
ELIZABETH M BROUGHAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2978 CENTREVILLE RD # B20171, HERNDON, VA 20171-6253
(703) 934-5000
Mailing address
14830 EDMAN CIR, CENTREVILLE, VA 20121-4497
(845) 479-0628
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306605921
VA
Other
Enumeration date
12/05/2021
Last updated
12/05/2021
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