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General NPI Number Information
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NPI Number | 1952269193
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Entity Type | Organization
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Legal Business Name | RIDGE INJURY & NEURO REHAB, LLC
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Dates
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Enumeration Date | 01/15/2026
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Last Update Date | 01/15/2026
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Provider Practice Location Address
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Address Line | 6405 MERRIMAN RD STE 103
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City | ROANOKE
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State | VA
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Zip | 24018-6600
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Country | US
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Telephone | 540-204-4066
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Fax |
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Provider Business Mailing Address
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Address Line | 6405 MERRIMAN RD STE 103
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City | ROANOKE
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State | VA
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Zip | 24018-6600
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Country | US
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Telephone | 540-204-4066
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. GARRETT CHARLES VAN NUTT
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Credential | DPT
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Telephone | 276-618-0854
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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