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Organization

BRISTOL THERAPY SERVICES LLC

Active
Other names
Preston Square Rehab & Wellness
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. BETTY H STEWART (OFFICE MANAGER)
(276) 645-0311
Entity
Organization

Contact information

Practice address
3130 LEE HIGHWAY, SUITE 210, BRISTOL, VA 24202-5943
(276) 645-0311
(276) 645-0302
Mailing address
3130 LEE HIGHWAY, SUITE 210, BRISTOL, VA 24202-5943
(276) 645-0311
(276) 645-0302

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010259053
VA
01
193497
ANTHEM
VA
01
700683
UHC-ACN
VA
01
7195849
AETNA
VA
01
VA0100
UHC OF RIVER VALLEY
VA
Enumeration date
01/17/2007
Last updated
11/29/2021
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