MEDICARE: BETTY RAGON LENOIR PT,DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	632	TN
2	2251X0800X	Orthopedic Physical Therapist	CPO39665T	VA
3	225100000X	Physical Therapist	CPO39665T	VA

General Provider Information

NPI Number	:	1164479721
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BETTY RAGON LENOIR PT,DPT

Provider Business Mailing Address
First Line	:	2313 WATERS MILL CIR
Second Line	:
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23235-2921
Country	:	US
Telephone Number	:	731-609-6293
Fax Number	:

Provider Business Practice Location Address
First Line	:	2313 WATERS MILL CIR
Second Line	:
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23235-2921
Country	:	US
Telephone Number	:	731-609-6293
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/28/2006
Last Update Date	:	04/14/2025

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