Healthcare Provider Details

I. General information

NPI: 1932247111
Provider Name (Legal Business Name): BRENDA LARRIMER MILLER PT,OCS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BRENDA LARRIMER PT

II. Dates (important events)

Enumeration Date: 02/01/2007
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

922 UNIVERSITY CITY BLVD STE 204
BLACKSBURG VA
24060-2753
US

IV. Provider business mailing address

922 UNIVERSITY CITY BLVD STE 204
BLACKSBURG VA
24060-2753
US

V. Phone/Fax

Practice location:
  • Phone: 540-315-3000
  • Fax: 540-739-3692
Mailing address:
  • Phone: 540-315-3000
  • Fax: 540-739-3692

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number2305003472
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: