Provider Demographics
NPI:1336444199
Name:DOBBINS-CLEMENTS, ERIKA L (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:L
Last Name:DOBBINS-CLEMENTS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:ERIKA
Other - Middle Name:L
Other - Last Name:DOBBINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:PO BOX 69030
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-9030
Mailing Address - Country:US
Mailing Address - Phone:757-873-2302
Mailing Address - Fax:757-873-2306
Practice Address - Street 1:1580 ARMORY DR STE B
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:VA
Practice Address - Zip Code:23851-2470
Practice Address - Country:US
Practice Address - Phone:757-562-0990
Practice Address - Fax:757-562-0496
Is Sole Proprietor?:No
Enumeration Date:2011-01-25
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305206572225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA9379803OtherAETNA
VA1336444199Medicaid
VAQ37382AMedicare PIN
VAC05954Medicare PIN