Healthcare Provider Details

I. General information

NPI: 1982128492
Provider Name (Legal Business Name): BRANDI CHEW BLASER PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 N HILL DR
WARRENTON VA
20186-2610
US

IV. Provider business mailing address

40 N HILL DR
WARRENTON VA
20186-2610
US

V. Phone/Fax

Practice location:
  • Phone: 540-341-1922
  • Fax: 540-341-1923
Mailing address:
  • Phone: 540-341-1922
  • Fax: 540-341-1923

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305211296
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: