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General NPI Number Information
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NPI Number | 1780186775
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Entity Type | Individual
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Provider Name | DINA LYNN REPHANN LPTA
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Gender | Female
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Dates
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Enumeration Date | 03/06/2018
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Last Update Date | 03/06/2018
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Provider Practice Location Address
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Address Line | 751 HILLSDALE DR
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22901-3300
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Country | US
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Telephone | 434-973-1155
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Fax |
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Provider Business Mailing Address
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Address Line | 96 RED CEDAR RD
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City | BARBOURSVILLE
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State | VA
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Zip | 22923-2762
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Country | US
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Telephone | 540-395-1786
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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 | 2306602416
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License Number State | VA
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