Provider Demographics
NPI:1891884219
Name:RASNAKE, ERIN BURGESS (PT)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:BURGESS
Last Name:RASNAKE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:449 CORNWALL DR
Mailing Address - Street 2:
Mailing Address - City:RUTHER GLEN
Mailing Address - State:VA
Mailing Address - Zip Code:22546-1128
Mailing Address - Country:US
Mailing Address - Phone:804-448-0384
Mailing Address - Fax:
Practice Address - Street 1:2300 CHARLES ST
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-3346
Practice Address - Country:US
Practice Address - Phone:540-368-1400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305202710225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist