Provider Demographics
NPI:1548597529
Name:WEST, VICKI HAYES (PT)
Entity Type:Individual
Prefix:MRS
First Name:VICKI
Middle Name:HAYES
Last Name:WEST
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7501 HERITAGE VILLAGE PLZ
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20155-3078
Mailing Address - Country:US
Mailing Address - Phone:571-248-6100
Mailing Address - Fax:571-248-6455
Practice Address - Street 1:7501 HERITAGE VILLAGE PLZ
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:VA
Practice Address - Zip Code:20155-3078
Practice Address - Country:US
Practice Address - Phone:571-248-6100
Practice Address - Fax:571-248-6455
Is Sole Proprietor?:No
Enumeration Date:2009-11-11
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305002779225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist