Provider Demographics
NPI:1609326735
Name:BIKKERS, VICTORIA LYNN MILLER (PT, DPT)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:LYNN MILLER
Last Name:BIKKERS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:LYNN
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:103 BEALE AVE
Mailing Address - Street 2:
Mailing Address - City:SMITHFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23430-1403
Mailing Address - Country:US
Mailing Address - Phone:757-644-1063
Mailing Address - Fax:757-644-4129
Practice Address - Street 1:319 MAIN ST STE 110
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:VA
Practice Address - Zip Code:23430-1326
Practice Address - Country:US
Practice Address - Phone:757-644-1063
Practice Address - Fax:757-644-4129
Is Sole Proprietor?:No
Enumeration Date:2016-10-13
Last Update Date:2023-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA23052106892251X0800X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA30017508150001Medicaid