Healthcare Provider Details

I. General information

NPI: 1801068069
Provider Name (Legal Business Name): ART BRONSORD & ASSOCIATES PHYSICAL THERAPY L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2008
Last Update Date: 03/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20098 ASHBROOK PL SUITE 190
ASHBURN VA
20147-3393
US

IV. Provider business mailing address

20098 ASHBROOK PL SUITE 190
ASHBURN VA
20147-3393
US

V. Phone/Fax

Practice location:
  • Phone: 703-723-5225
  • Fax:
Mailing address:
  • Phone: 703-723-5225
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305003034
License Number StateVA

VIII. Authorized Official

Name: MR. ARTHUR C BRONSORD
Title or Position: OWNER / PHYSICAL THERAPIST
Credential: PHYSICAL THERAPIST
Phone: 703-723-5225