Provider Demographics
NPI:1366423543
Name:WEIL, WENDY WEINBERG (PT ATC)
Entity type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:WEINBERG
Last Name:WEIL
Suffix:
Gender:F
Credentials:PT ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:6515 ELNIDO DR
Mailing Address - Street 2:
Mailing Address - City:MC LEAN
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:MC LEAN
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
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA23050023902251X0800X, 2251S0007X
VA230500239225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1760527584OtherNPI