Provider Demographics
NPI:1497057251
Name:WARLITNER, THERESA
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:
Last Name:WARLITNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3935 SUNNYSIDE DR
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-2328
Mailing Address - Country:US
Mailing Address - Phone:540-568-8311
Mailing Address - Fax:540-437-8783
Practice Address - Street 1:3935 SUNNYSIDE DR
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-2328
Practice Address - Country:US
Practice Address - Phone:540-568-8311
Practice Address - Fax:540-437-8783
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-30
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2306601757225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant