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NPI Code Detail

MEDICARE: EVA GAY SELWYN LPTA

MEDICARE:   EVA GAY SELWYN  LPTA
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
1225200000XPhysical Therapy Assistant2306001242VA

General Provider Information

NPI Number : 1720295942
Entity Type Code : Individual
Provider Name (Legal Business Name) : EVA GAY SELWYN LPTA
Provider Business Mailing Address
First Line : 549 PARK AVE
Second Line :
City : WOODSTOCK
State : VA
Zip : 22664-1244
Country : US
Telephone Number : 540-459-5940
Fax Number :
Provider Business Practice Location Address
First Line : 315 E LEE HWY
Second Line :
City : NEW MARKET
State : VA
Zip : 22844-3103
Country : US
Telephone Number : 540-740-8041
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2007
Last Update Date : 07/08/2007

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Directions to “ EVA GAY SELWYN LPTA” Practice Location

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