Provider Demographics
NPI:1689761918
Name:LOVINGSTON PHYSICAL THERAPY
Entity Type:Organization
Organization Name:LOVINGSTON PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:P.T. AND OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:J
Authorized Official - Last Name:BOECKMANN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:434-263-6200
Mailing Address - Street 1:PO BOX 275
Mailing Address - Street 2:
Mailing Address - City:LOVINGSTON
Mailing Address - State:VA
Mailing Address - Zip Code:22949-0275
Mailing Address - Country:US
Mailing Address - Phone:434-263-6200
Mailing Address - Fax:434-263-6202
Practice Address - Street 1:8445 THOMAS NELSON HWY.
Practice Address - Street 2:
Practice Address - City:LOVINGSTON
Practice Address - State:VA
Practice Address - Zip Code:22949
Practice Address - Country:US
Practice Address - Phone:434-263-6200
Practice Address - Fax:434-263-6202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2012-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
C08916Medicare ID - Type Unspecified