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General NPI Number Information
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NPI Number | 1558645887
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Entity Type | Individual
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Provider Name | JONATHAN J NGUYEN PTA
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Gender | Male
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Dates
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Enumeration Date | 10/05/2011
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Last Update Date | 10/05/2011
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Provider Practice Location Address
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Address Line | 3833 FAIRFAX DR
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City | ARLINGTON
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State | VA
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Zip | 22203-1772
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Country | US
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Telephone | 301-540-6140
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Fax | 301-540-5190
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Provider Business Mailing Address
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Address Line | 20410 CENTURY BLVD NRH REGIONAL REHAB, SUITE 215
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City | GERMANTOWN
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State | MD
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Zip | 20874-1186
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Country | US
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Telephone | 301-540-6140
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Fax | 301-540-5190
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 2306603136
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License Number State | VA
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