Provider Demographics
NPI:1093419673
Name:WINESETT, JOSEPH (LPTA)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:WINESETT
Suffix:
Gender:M
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1054 BURNETT RD
Mailing Address - Street 2:
Mailing Address - City:WOODLAWN
Mailing Address - State:VA
Mailing Address - Zip Code:24381-4928
Mailing Address - Country:US
Mailing Address - Phone:276-733-1518
Mailing Address - Fax:
Practice Address - Street 1:3400 SOUTHPOINT DR
Practice Address - Street 2:
Practice Address - City:BLACKSBURG
Practice Address - State:VA
Practice Address - Zip Code:24060-1261
Practice Address - Country:US
Practice Address - Phone:540-792-7076
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-28
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2306606163225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant