Provider Demographics
NPI:1841595881
Name:LANIER, VIRGINIA GATES (DPT)
Entity Type:Individual
Prefix:DR
First Name:VIRGINIA
Middle Name:GATES
Last Name:LANIER
Suffix:
Gender:F
Credentials:DPT
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Mailing Address - Street 1:1034 S BRENTWOOD BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:RICHMOND HEIGHTS
Mailing Address - State:MO
Mailing Address - Zip Code:63117
Mailing Address - Country:US
Mailing Address - Phone:314-644-1978
Mailing Address - Fax:314-644-5730
Practice Address - Street 1:6224 FAYETTEVILLE RD.
Practice Address - Street 2:SUITE 101
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713
Practice Address - Country:US
Practice Address - Phone:314-644-1978
Practice Address - Fax:314-644-5730
Is Sole Proprietor?:No
Enumeration Date:2011-01-24
Last Update Date:2013-04-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2009021413225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO266641Medicare Oscar/Certification