Healthcare Provider Details

I. General information

NPI: 1588342018
Provider Name (Legal Business Name): REENU JOSE ALAPPAT PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2023
Last Update Date: 07/05/2023
Certification Date: 07/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 NATIONWIDE DR
LYNCHBURG VA
24502-4272
US

IV. Provider business mailing address

309 SPRING LAKE RD
FOREST VA
24551-1971
US

V. Phone/Fax

Practice location:
  • Phone: 434-200-6933
  • Fax:
Mailing address:
  • Phone: 201-321-6198
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305215447
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: