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General NPI Number Information
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NPI Number | 1376973578
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Entity Type | Individual
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Provider Name | BARRET BLEVINS PT, DPT, ATC
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Gender | Male
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Dates
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Enumeration Date | 11/25/2013
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Last Update Date | 11/04/2024
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Provider Practice Location Address
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Address Line | 24530 FALCON PLACE BLVD SUITE 203
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City | ABINGDON
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State | VA
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Zip | 24211-7665
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Country | US
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Telephone | 276-619-6195
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Fax | 276-619-3878
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Provider Business Mailing Address
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Address Line | 1021 W OAKLAND AVE STE 310
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City | JOHNSON CITY
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State | TN
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Zip | 37604-2192
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Country | US
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Telephone | 423-952-2111
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Fax | 423-282-1657
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2305205558
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License Number State | VA
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