Brian D Iveson, DSCPT
Individual provider Active NPI Physical Therapist · Quantico, VA
NPI 1962476804 · NPPES record last updated Apr 3, 2024
Key facts
- NPI
- 1962476804
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 5501010161 (MI)
- Practice address
- 3259 Catlin Ave
Quantico, VA 22134-5109 - Phone
- (703) 784-3205
- NPI assigned
- Feb 16, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5501010161 | MI | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5501010161 | MI | Yes |
Addresses
Primary practice location
3259 Catlin Ave
Quantico, VA 22134-5109
Mailing address
3259 Catlin Ave
Quantico, VA 22134-5109
Phone (703) 784-3205
Other providers in Quantico, VA
- Keiron A Holmes
- Christy Ann Hood
- Jessica Mahela Hru
- Kim-Nga Huynh
- Dawn M Ingram
- Ju Ri Jeong
- Herschel Lee Jones
- Stacy Michelle Jones
- Kevin Dale Joyner
- Julie Jung
All providers in Quantico, VA · Physical Therapist in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 3, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.