Provider Demographics
NPI:1982848131
Name:VANARASA, DHANARAJ KUMAR (PT,MPT,WCC)
Entity Type:Individual
Prefix:MR
First Name:DHANARAJ
Middle Name:KUMAR
Last Name:VANARASA
Suffix:
Gender:M
Credentials:PT,MPT,WCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8544 EVERSHAM RD
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23294-5120
Mailing Address - Country:US
Mailing Address - Phone:909-800-0045
Mailing Address - Fax:
Practice Address - Street 1:906 THOMPSON ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:VA
Practice Address - Zip Code:23005-1128
Practice Address - Country:US
Practice Address - Phone:804-798-3291
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-30
Last Update Date:2016-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305205770225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist