Healthcare Provider Details

I. General information

NPI: 1275844276
Provider Name (Legal Business Name): ASHLEY DAWN GLOVER PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2010
Last Update Date: 07/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44 CLIFTON ST
LYNCHBURG VA
24501-1422
US

IV. Provider business mailing address

1948 THOMSON DR
LYNCHBURG VA
24501-1009
US

V. Phone/Fax

Practice location:
  • Phone: 434-528-1848
  • Fax:
Mailing address:
  • Phone: 434-845-9053
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305206465
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: