Provider Demographics
NPI:1619023447
Name:APPALACHIAN PHYSICAL THERAPY, INC.
Entity Type:Organization
Organization Name:APPALACHIAN PHYSICAL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:F
Authorized Official - Last Name:WHITEFORD
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:540-434-1699
Mailing Address - Street 1:171 E SPRINGBROOK RD
Mailing Address - Street 2:
Mailing Address - City:BROADWAY
Mailing Address - State:VA
Mailing Address - Zip Code:22815-9526
Mailing Address - Country:US
Mailing Address - Phone:540-901-9501
Mailing Address - Fax:540-901-8773
Practice Address - Street 1:171 E SPRINGBROOK RD
Practice Address - Street 2:
Practice Address - City:BROADWAY
Practice Address - State:VA
Practice Address - Zip Code:22815-9526
Practice Address - Country:US
Practice Address - Phone:540-901-9501
Practice Address - Fax:540-901-8773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2015-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305002987174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA194034OtherANTHEM
VA194034OtherANTHEM