Organization Name: | LAKE RIDGE PHYSICAL THERAPY, LLC. |
NPI Number: | 1144404039 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | GARY F BAKER (INSURANCE SPECIALIST) |
Mailing Address: | 5139 Waterway Dr Montclair |
State: | VA US |
Postal Code: | 220251261 |
Phone Number: | 7037306400 |
Fax Number: | 7037309212 |
NPI Enumeration Date: | 12/27/2007 |
NPI Last Update Date: | 12/27/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |