| NPI | 1083928949 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATASHA R BLANTON Owner 540-327-1740 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305204166) |
| Additional Taxonomies | 2251G0304X Physical Therapist, Geriatrics (Licence: VA 2305204166) |
| 2251P0200X Physical Therapist, Pediatrics (Licence: VA 2305204166) | |
| 2251S0007X Physical Therapist, Sports (Licence: VA 2305204166) | |
| 2251X0800X Physical Therapist, Orthopedic (Licence: VA 2305204166) | |
| Enumeration Date | 2010-08-03 |
| Last Update Date | 2014-09-17 |