Provider Demographics
NPI:1750834560
Name:EGLOFF, JOSH (PT, DPT)
Entity Type:Individual
Prefix:
First Name:JOSH
Middle Name:
Last Name:EGLOFF
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20347 TIMBERLAKE RD STE B
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-7352
Mailing Address - Country:US
Mailing Address - Phone:434-845-9053
Mailing Address - Fax:
Practice Address - Street 1:44 CLIFTON ST
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24501-1422
Practice Address - Country:US
Practice Address - Phone:434-845-9053
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-27
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305210489225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist