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NPI Code Detail

MEDICARE: ALICIA LYNNE ANCARROW PT

MEDICARE: ALICIA LYNNE ANCARROW PT
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
1225100000XPhysical Therapist2305203365VA

General Provider Information

NPI Number : 1679782551
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALICIA LYNNE ANCARROW PT
Provider Business Mailing Address
First Line : 7067 WESBEAM DR
Second Line :
City : MECHANICSVILLE
State : VA
Zip : 23111-7007
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7090 COVENANT WOODS DR
Second Line :
City : MECHANICSVILLE
State : VA
Zip : 23111-7025
Country : US
Telephone Number : 804-569-8697
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2007
Last Update Date : 07/08/2007

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Directions to “ ALICIA LYNNE ANCARROW PT” Practice Location

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