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General NPI Number Information
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NPI Number | 1972556199
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Entity Type | Organization
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Legal Business Name | DUFFIELD PHYSICAL THERAPY AND FITNESS
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Dates
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Enumeration Date | 05/18/2006
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Last Update Date | 09/26/2007
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Provider Practice Location Address
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Address Line | 134 CECIL D QUILLEN DR
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City | DUFFIELD
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State | VA
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Zip | 24244-9726
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Country | US
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Telephone | 276-431-3141
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Fax | 276-431-3143
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Provider Business Mailing Address
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Address Line | 134 CECIL D QUILLEN DR
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City | DUFFIELD
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State | VA
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Zip | 24244-9726
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Country | US
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Telephone | 276-431-3141
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Fax | 276-431-3143
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Authorized Official
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Title or Position | CHIEF MANAGER
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Name | MR. DEWAYNE STEVEN GARRETT
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Credential | LPTA
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Telephone | 12763562701
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number |
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License Number State |
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