Provider Demographics
NPI:1164744827
Name:PUREFOY, LASHAUNDA (PT)
Entity Type:Individual
Prefix:
First Name:LASHAUNDA
Middle Name:
Last Name:PUREFOY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 GREENSPRING DR
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22554-1752
Mailing Address - Country:US
Mailing Address - Phone:540-373-7133
Mailing Address - Fax:540-373-0068
Practice Address - Street 1:90 GREENSPRING DR
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22554-1752
Practice Address - Country:US
Practice Address - Phone:540-373-7133
Practice Address - Fax:540-373-0068
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-23
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305206373225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist