Provider Demographics
NPI:1184900565
Name:HAMMACK, ABBY LEIGH (DPT)
Entity type:Individual
Prefix:
First Name:ABBY
Middle Name:LEIGH
Last Name:HAMMACK
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ABBY
Other - Middle Name:LEIGH
Other - Last Name:BURKHOLDER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPT
Mailing Address - Street 1:5254 POTOMAC DR STE A
Mailing Address - Street 2:
Mailing Address - City:KING GEORGE
Mailing Address - State:VA
Mailing Address - Zip Code:22485-5832
Mailing Address - Country:US
Mailing Address - Phone:540-709-1147
Mailing Address - Fax:
Practice Address - Street 1:5254 POTOMAC DR STE A
Practice Address - Street 2:
Practice Address - City:KING GEORGE
Practice Address - State:VA
Practice Address - Zip Code:22485-5832
Practice Address - Country:US
Practice Address - Phone:540-709-1147
Practice Address - Fax:855-262-0935
Is Sole Proprietor?:No
Enumeration Date:2011-10-28
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305206271225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist