Provider Demographics
NPI:1760527584
Name:WENDY WEIL, PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:WENDY WEIL, PHYSICAL THERAPY, LLC
Other - Org Name:WENDY W. WEIL PT, ATC, OCS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PHYSICAL THERAPIST, OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:WEINBERG
Authorized Official - Last Name:WEIL
Authorized Official - Suffix:
Authorized Official - Credentials:PT, ATC, OCS
Authorized Official - Phone:703-847-0145
Mailing Address - Street 1:6515 EL NIDO DR
Mailing Address - Street 2:
Mailing Address - City:MCLEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-4633
Mailing Address - Country:US
Mailing Address - Phone:703-847-0145
Mailing Address - Fax:703-847-6130
Practice Address - Street 1:6515 EL NIDO DR
Practice Address - Street 2:
Practice Address - City:MCLEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-4633
Practice Address - Country:US
Practice Address - Phone:703-847-0145
Practice Address - Fax:703-847-6130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305002390261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAG02439Medicare PIN