Healthcare Provider Details

I. General information

NPI: 1285731851
Provider Name (Legal Business Name): JULIA CASTLEBERRY PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 COLLEGE ST
CHRISTIANSBURG VA
24073-2958
US

IV. Provider business mailing address

3060 LICK RUN RD
BLACKSBURG VA
24060-1024
US

V. Phone/Fax

Practice location:
  • Phone: 540-382-1492
  • Fax:
Mailing address:
  • Phone: 540-951-5303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305005799
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: