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General NPI Number Information
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NPI Number | 1396706065
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Entity Type | Organization
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Legal Business Name | BLUE RIDGE THERAPY ASSOCIATES, INC.
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Dates
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Enumeration Date | 03/31/2006
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Last Update Date | 08/21/2024
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Provider Practice Location Address
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Address Line | 1912 MEMORIAL AVE
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City | LYNCHBURG
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State | VA
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Zip | 24501-1708
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Country | US
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Telephone | 434-845-8765
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Fax | 434-845-8467
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Provider Business Mailing Address
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Address Line | 1912 MEMORIAL AVE
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City | LYNCHBURG
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State | VA
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Zip | 24501-1708
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Country | US
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Telephone | 434-845-8765
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Fax | 434-845-8467
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Authorized Official
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Title or Position | PRESIDENT
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Name | AMY SHROCK
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Credential | M.S., CCC-SLP
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Telephone | 434-845-8765
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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