Provider Demographics
NPI:1073801304
Name:WAMSLEY-BARR, ANDREA B (DPT)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:B
Last Name:WAMSLEY-BARR
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3221 PEOPLES DR
Mailing Address - Street 2:STE 110
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-7622
Mailing Address - Country:US
Mailing Address - Phone:540-638-2478
Mailing Address - Fax:540-908-4801
Practice Address - Street 1:3221 PEOPLES DR
Practice Address - Street 2:STE 110
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-7622
Practice Address - Country:US
Practice Address - Phone:540-638-2478
Practice Address - Fax:540-908-4801
Is Sole Proprietor?:No
Enumeration Date:2011-07-20
Last Update Date:2014-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305206880225100000X
OHPT.013668225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0075660Medicaid
WV3810023244Medicaid
OHH094100Medicare PIN