Individual
ANDREW KEITH MAZUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
24430 STONE SPRINGS BLVD STE 400, DULLES, VA 20166-2268
(703) 776-5040
(703) 776-5047
Mailing address
PO BOX 37189, BALTIMORE, MD 21297-3189
(571) 423-5699
(571) 423-5698
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305205338
VA
225100000X
Physical Therapist
2502
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1902899719
—
VA
Enumeration date
08/26/2005
Last updated
01/09/2023
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