Healthcare Provider Details

I. General information

NPI: 1851211148
Provider Name (Legal Business Name): BJB PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8130 BOONE BLVD STE 110
VIENNA VA
22182-2640
US

IV. Provider business mailing address

8130 BOONE BLVD STE 110
VIENNA VA
22182-2640
US

V. Phone/Fax

Practice location:
  • Phone: 240-480-4553
  • Fax: 301-972-1068
Mailing address:
  • Phone: 240-480-4553
  • Fax: 301-972-1068

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. BEHZAD JAFARI
Title or Position: OWNER
Credential:
Phone: 703-987-8739