Provider Demographics
NPI:1073112736
Name:BLEVINS, ANNA (LPTA)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:BLEVINS
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:
Other - Last Name:ABBOTT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPTA
Mailing Address - Street 1:292 ALLEGHANY SPRING RD APT 3
Mailing Address - Street 2:
Mailing Address - City:SHAWSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24162-1887
Mailing Address - Country:US
Mailing Address - Phone:540-892-3839
Mailing Address - Fax:
Practice Address - Street 1:2387 WARM HEARTH DR
Practice Address - Street 2:
Practice Address - City:BLACKSBURG
Practice Address - State:VA
Practice Address - Zip Code:24060-6281
Practice Address - Country:US
Practice Address - Phone:540-552-9176
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-22
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2306605023225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAB69726920OtherDRIVERS LICENSE