Provider Demographics
NPI:1407576804
Name:WU, ELIZABETH (DPT, PT)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:WU
Suffix:
Gender:F
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1769
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20118-1769
Mailing Address - Country:US
Mailing Address - Phone:703-208-1002
Mailing Address - Fax:
Practice Address - Street 1:8550 LEE HWY STE 450
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-1519
Practice Address - Country:US
Practice Address - Phone:703-208-1002
Practice Address - Fax:703-208-1127
Is Sole Proprietor?:No
Enumeration Date:2022-08-29
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VACP029528T225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist