Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 2305206055 | VA |
NPI | 1003078833 |
---|---|
Provider Name | Bhumi Anish Desai |
First Address | Chantilly, VA 20152-4397 |
Second Address | Chantilly, VA 20152-4113 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2008 |
Last Update Date | 29/07/2020 |