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General NPI Number Information
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NPI Number | 1649876178
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Entity Type | Individual
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Provider Name | BREONA L MILLNER DPT
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Gender | Female
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Dates
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Enumeration Date | 12/09/2020
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Last Update Date | 10/27/2023
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Provider Practice Location Address
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Address Line | 124 OLD POTOMAC CHURCH RD SUITE 201
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City | STAFFORD
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State | VA
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Zip | 22554-7257
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Country | US
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Telephone | 571-427-4378
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Fax | 571-833-4378
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Provider Business Mailing Address
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Address Line | 3695 FETTLER PARK DRIVE
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City | DUMFRIES
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State | VA
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Zip | 22025-2049
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Country | US
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Telephone | 571-427-4378
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Fax | 571-833-4378
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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 | 2305214767
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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