Provider Demographics
NPI:1013005032
Name:LE, JOHN NGUYEN (DPT)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:NGUYEN
Last Name:LE
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:JOHNNY
Other - Middle Name:
Other - Last Name:LE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPT
Mailing Address - Street 1:7315 OLIVER ST
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-1229
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3414 OLANDWOOD CT
Practice Address - Street 2:
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832-1384
Practice Address - Country:US
Practice Address - Phone:301-774-0624
Practice Address - Fax:301-774-4545
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic