Provider Demographics
NPI:1659644938
Name:EAGLER, LEE ANN WHEAT (PT)
Entity Type:Individual
Prefix:
First Name:LEE
Middle Name:ANN WHEAT
Last Name:EAGLER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 LAKESIDE DR
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24501-3113
Mailing Address - Country:US
Mailing Address - Phone:434-544-8881
Mailing Address - Fax:
Practice Address - Street 1:300 MONTICELLO AVE STE A
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24501-5616
Practice Address - Country:US
Practice Address - Phone:434-544-8881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-16
Last Update Date:2012-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA23052036672251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics