Provider Demographics
NPI:1871669382
Name:PANTOPS PHYSICAL THERAPY, PC
Entity Type:Organization
Organization Name:PANTOPS PHYSICAL THERAPY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:434-245-6472
Mailing Address - Street 1:1490 PANTOPS MOUNTAIN PL
Mailing Address - Street 2:SUITE 202
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-4601
Mailing Address - Country:US
Mailing Address - Phone:434-245-6472
Mailing Address - Fax:434-245-6474
Practice Address - Street 1:1490 PANTOPS MOUNTAIN PL
Practice Address - Street 2:SUITE 202
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-4601
Practice Address - Country:US
Practice Address - Phone:434-245-6472
Practice Address - Fax:434-245-6474
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-27
Last Update Date:2013-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
C09575OtherMEDICARE PTAN
VA010206383Medicaid
C09575OtherMEDICARE PTAN
VA1871669382Medicare PIN