Provider Demographics
NPI:1346506292
Name:VARNEY, BRENT ALLEN (PTA)
Entity Type:Individual
Prefix:
First Name:BRENT
Middle Name:ALLEN
Last Name:VARNEY
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1271 BEAR CREEK RD
Mailing Address - Street 2:
Mailing Address - City:ATKINS
Mailing Address - State:VA
Mailing Address - Zip Code:24311-3212
Mailing Address - Country:US
Mailing Address - Phone:540-818-6486
Mailing Address - Fax:
Practice Address - Street 1:1271 BEAR CREEK RD
Practice Address - Street 2:
Practice Address - City:ATKINS
Practice Address - State:VA
Practice Address - Zip Code:24311-3212
Practice Address - Country:US
Practice Address - Phone:540-818-6486
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-04
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2306601443225200000X
NVA-0560225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant