Provider Demographics
NPI:1073818415
Name:BERNABE, ARNEL (PT)
Entity Type:Individual
Prefix:MR
First Name:ARNEL
Middle Name:
Last Name:BERNABE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 VIRGINIA AVE
Mailing Address - Street 2:
Mailing Address - City:FARMVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23901-4017
Mailing Address - Country:US
Mailing Address - Phone:434-414-6609
Mailing Address - Fax:
Practice Address - Street 1:205 VIRGINIA AVE
Practice Address - Street 2:
Practice Address - City:FARMVILLE
Practice Address - State:VA
Practice Address - Zip Code:23901-4017
Practice Address - Country:US
Practice Address - Phone:434-414-6609
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-17
Last Update Date:2011-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305206142225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist