Provider Demographics
NPI:1841605045
Name:DOYLE, GEORGINA
Entity Type:Individual
Prefix:
First Name:GEORGINA
Middle Name:
Last Name:DOYLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:432 MORNINGSIDE DR
Mailing Address - Street 2:APT A
Mailing Address - City:LEXINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:24450-2739
Mailing Address - Country:US
Mailing Address - Phone:540-319-1245
Mailing Address - Fax:
Practice Address - Street 1:432 MORNINGSIDE DR
Practice Address - Street 2:APT A
Practice Address - City:LEXINGTON
Practice Address - State:VA
Practice Address - Zip Code:24450-2739
Practice Address - Country:US
Practice Address - Phone:540-319-1245
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-25
Last Update Date:2014-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2306603827225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant