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General NPI Number Information
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NPI Number | 1346506292
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Entity Type | Individual
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Provider Name | BRENT ALLEN VARNEY PTA
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Gender | Male
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Dates
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Enumeration Date | 04/04/2012
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Last Update Date | 04/04/2012
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Provider Practice Location Address
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Address Line | 1271 BEAR CREEK RD
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City | ATKINS
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State | VA
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Zip | 24311-3212
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Country | US
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Telephone | 540-818-6486
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Fax |
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Provider Business Mailing Address
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Address Line | 1271 BEAR CREEK RD
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City | ATKINS
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State | VA
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Zip | 24311-3212
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Country | US
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Telephone | 540-818-6486
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 2306601443
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | A-0560
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License Number State | NV
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