Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jonathan Phuong

Individual provider Physical Therapy Assistant · NPI 1073383600

Jonathan Phuong is a Physical Therapy Assistant in Lake Ridge, Virginia. Licensed in Virginia. Registered with an NPI since 2024.

Licensed in
VA
In the registry since
2024

Practice location Address checks out

12825 Minnieville Rd Ste 201
Lake Ridge, VA 22192-3602
Phone: (703) 647-3130
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence 2306605924 (VA)

Record details

NPI number1073383600
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJanuary 4, 2024
Last updated in NPPESJanuary 4, 2024
Certification dateJanuary 4, 2024
Mailing address6654 Rock Island Rd Apt 100, Springfield, VA 22150-1974

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