Healthcare Provider Details

I. General information

NPI: 1023023678
Provider Name (Legal Business Name): CAWH REHABILITATION SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 08/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 S MAIN ST SUITE 8
BLACKSBURG VA
24060-6600
US

IV. Provider business mailing address

1901 S MAIN ST SUITE 8
BLACKSBURG VA
24060-6600
US

V. Phone/Fax

Practice location:
  • Phone: 540-552-2294
  • Fax: 540-552-2296
Mailing address:
  • Phone: 540-552-3422
  • Fax: 540-552-2296

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. STACY LEIGH NEILY
Title or Position: ADMINISTRATIVE ASSISTANT
Credential:
Phone: 540-552-3422