Provider Demographics
NPI:1780681106
Name:ATER, ABBEY M (MPT)
Entity type:Individual
Prefix:
First Name:ABBEY
Middle Name:M
Last Name:ATER
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:ABBEY
Other - Middle Name:M
Other - Last Name:GINDLESBERGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:825 DAVIS ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:BLACKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24060-7009
Mailing Address - Country:US
Mailing Address - Phone:540-552-5100
Mailing Address - Fax:540-552-5700
Practice Address - Street 1:825 DAVIS ST
Practice Address - Street 2:SUITE B
Practice Address - City:BLACKSBURG
Practice Address - State:VA
Practice Address - Zip Code:24060-7009
Practice Address - Country:US
Practice Address - Phone:540-552-5100
Practice Address - Fax:540-552-5700
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2015-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-03308225100000X
MO2007036882225100000X
VA2305206879225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO39764044OtherBCBS
KS39764014OtherBCBS
MO39764034OtherBCBS
MO39764054OtherBCBS
MO39764024OtherBCBS
MO39764044OtherBCBS
MO39764054OtherBCBS
KST29000001Medicare PIN
MOT07000002Medicare PIN
MO39764024OtherBCBS