Healthcare Provider Details

I. General information

NPI: 1861519084
Provider Name (Legal Business Name): ONA-MARIA ASBURY LPTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 LITTON LN
BLACKSBURG VA
24060-6399
US

IV. Provider business mailing address

303 W MAIN ST APT. 12
RADFORD VA
24141-1773
US

V. Phone/Fax

Practice location:
  • Phone: 540-443-3436
  • Fax: 540-961-1067
Mailing address:
  • Phone: 540-320-7023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number2306601953
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: