Healthcare Provider Details

I. General information

NPI: 1629010160
Provider Name (Legal Business Name): LLOYD HORACE GIVAN P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2006
Last Update Date: 04/07/2021
Certification Date: 04/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1230 CEDARS CT
CHARLOTTESVILLE VA
22903-5800
US

IV. Provider business mailing address

1230 CEDARS CT STE 106
CHARLOTTESVILLE VA
22903-5800
US

V. Phone/Fax

Practice location:
  • Phone: 434-220-0805
  • Fax: 434-220-0806
Mailing address:
  • Phone: 434-220-0805
  • Fax: 434-220-0806

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number2305003964
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305003964
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: