MEDICARE: MR. CARL M TORODE P.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	2305001479	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	318235	OTHER	VA	BLUE CROSS BLUE SHIELD
2	210448	OTHER	VA	SOUTHERN HEALTH

General Provider Information

NPI Number	:	1134119670
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CARL M TORODE P.T.

Provider Business Mailing Address
First Line	:	PO BOX 720
Second Line	:
City	:	AMHERST
State	:	VA
Zip	:	24521-0720
Country	:	US
Telephone Number	:	434-946-1314
Fax Number	:	434-946-1083

Provider Business Practice Location Address
First Line	:	210 S MAIN ST
Second Line	:
City	:	AMHERST
State	:	VA
Zip	:	24521-2616
Country	:	US
Telephone Number	:	434-946-1314
Fax Number	:	434-946-1083

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/26/2005
Last Update Date	:	07/08/2007

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