Provider Demographics
NPI:1962018200
Name:GREENBRIER VALLEY PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:GREENBRIER VALLEY PHYSICAL THERAPY, LLC
Other - Org Name:RIDGELINE-BATH PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:STREETER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-699-9395
Mailing Address - Street 1:PO BOX 932184
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:31193-4912
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9292 SAM SNEAD HWY UNIT 3
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:VA
Practice Address - Zip Code:24445-2928
Practice Address - Country:US
Practice Address - Phone:540-839-2224
Practice Address - Fax:540-839-2244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-22
Last Update Date:2023-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty