Healthcare Provider Details

I. General information

NPI: 1093543167
Provider Name (Legal Business Name): BRIAN ERIK GUZMAN-COMAS DPT, ATC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2024
Last Update Date: 07/22/2024
Certification Date: 07/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19455 DEERFIELD AVE STE 306
LANSDOWNE VA
20176-8102
US

IV. Provider business mailing address

19455 DEERFIELD AVE STE 306
LANSDOWNE VA
20176-8102
US

V. Phone/Fax

Practice location:
  • Phone: 703-729-5010
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number2305216462
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: