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General NPI Number Information
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NPI Number | 1811549744
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Entity Type | Individual
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Provider Name | TERESA DREW
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Gender | Female
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Dates
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Enumeration Date | 07/11/2019
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Last Update Date | 12/03/2020
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Provider Practice Location Address
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Address Line | 13168 NEW PARKLAND DR
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City | OAK HILL
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State | VA
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Zip | 20171-3821
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Country | US
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Telephone | 571-277-9703
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Fax |
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Provider Business Mailing Address
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Address Line | 13168 NEW PARKLAND DR
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City | OAK HILL
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State | VA
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Zip | 20171-3821
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Country | US
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Telephone |
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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 | 171W00000X
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Taxonomy Name | Contractor
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 2306601294
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License Number State | VA
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