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General NPI Number Information
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NPI Number | 1447687389
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Entity Type | Individual
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Provider Name | BRIAN MAHER DPT
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Gender | Male
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Dates
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Enumeration Date | 10/10/2013
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Last Update Date | 10/10/2013
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Provider Practice Location Address
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Address Line | 1725 LASKIN RD SUITE 535
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City | VIRGINIA BEACH
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State | VA
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Zip | 23454-4558
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Country | US
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Telephone | 757-252-4800
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Fax |
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Provider Business Mailing Address
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Address Line | 608 SHOREHAM CT 304
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City | VIRGINIA BEACH
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State | VA
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Zip | 23451-4169
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Country | US
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Telephone | 757-724-3370
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2305207923
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License Number State | VA
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