Organization
BPT WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BROADWIN B ADESEGUN DPT (OWNER)
(703) 826-3743
Entity
Organization
Contact information
Practice address
657 NATHANIEL CHASE LN, HERNDON, VA 20170-4970
(571) 235-7898
(206) 339-2959
Mailing address
657 NATHANIEL CHASE LN, HERNDON, VA 20170-4970
(703) 826-3743
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305204402
VA
Other
Enumeration date
05/21/2018
Last updated
06/09/2022
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