Healthcare Provider Details

I. General information

NPI: 1114070935
Provider Name (Legal Business Name): WEST POINT PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 12/07/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 WINTERS ST SUITE 106
WEST POINT VA
23181-9534
US

IV. Provider business mailing address

100 WINTERS ST SUITE 106
WEST POINT VA
23181-9534
US

V. Phone/Fax

Practice location:
  • Phone: 804-843-9033
  • Fax: 804-843-9037
Mailing address:
  • Phone: 804-843-9033
  • Fax: 804-843-9037

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305204769
License Number StateVA

VIII. Authorized Official

Name: MR. DAVID JOE DURHAM
Title or Position: PRESIDENT
Credential: DPT
Phone: 804-843-9033