Provider Demographics
NPI:1629010160
Name:GIVAN, LLOYD HORACE (PT)
Entity Type:Individual
Prefix:MR
First Name:LLOYD
Middle Name:HORACE
Last Name:GIVAN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1230 CEDARS CT STE 106
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903-5800
Mailing Address - Country:US
Mailing Address - Phone:434-220-0805
Mailing Address - Fax:434-220-0806
Practice Address - Street 1:1230 CEDARS CT
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22903-5800
Practice Address - Country:US
Practice Address - Phone:434-220-0805
Practice Address - Fax:434-220-0806
Is Sole Proprietor?:No
Enumeration Date:2006-06-11
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305003964174400000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA00V506T74Medicare ID - Type UnspecifiedINDIVIDUAL NUMBERT