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General NPI Number Information
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NPI Number | 1003890815
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Entity Type | Organization
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Legal Business Name | REHABILITATION SERVICES OF DANVILLE
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Dates
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Enumeration Date | 12/05/2005
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Last Update Date | 07/15/2011
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Provider Practice Location Address
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Address Line | 990 MAIN ST SUITE 100
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City | DANVILLE
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State | VA
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Zip | 24541
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Country | US
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Telephone | 540-772-8022
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Fax | 540-772-0294
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Provider Business Mailing Address
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Address Line | PO BOX 8833
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City | ROANOKE
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State | VA
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Zip | 24014-0745
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Country | US
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Telephone | 540-772-8022
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Fax | 540-772-0294
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | MR. MARK S LUCAS
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Credential |
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Telephone | 540-772-8022
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 0105000005
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License Number State | VA
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