Provider Demographics
NPI:1477758118
Name:LEVAN, NOEL SIMMS (OTL)
Entity Type:Individual
Prefix:MR
First Name:NOEL
Middle Name:SIMMS
Last Name:LEVAN
Suffix:
Gender:M
Credentials:OTL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:156 MARYLAND AVE
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-1856
Mailing Address - Country:US
Mailing Address - Phone:540-383-7028
Mailing Address - Fax:
Practice Address - Street 1:1501 VIRGINIA AVE
Practice Address - Street 2:VIRGINIA MENNONITE RETIREMENT COMMUNITY
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22802-2452
Practice Address - Country:US
Practice Address - Phone:540-564-3400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-20
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119001144225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist