Provider Demographics
NPI:1962834911
Name:GUNTHER, GEOFFREY A (DPT)
Entity Type:Individual
Prefix:
First Name:GEOFFREY
Middle Name:A
Last Name:GUNTHER
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 WILLOW LAWN DR
Mailing Address - Street 2:STE 230
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-3003
Mailing Address - Country:US
Mailing Address - Phone:804-340-1193
Mailing Address - Fax:804-340-1930
Practice Address - Street 1:1700 WILLOW LAWN DR
Practice Address - Street 2:STE 230
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-3003
Practice Address - Country:US
Practice Address - Phone:804-340-1193
Practice Address - Fax:804-340-1930
Is Sole Proprietor?:No
Enumeration Date:2013-08-01
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305208105225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist