Organization
BLUE RIDGE THERAPY ASSOCIATES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY SHROCK M.S., CCC-SLP (PRESIDENT)
(434) 845-8765
Entity
Organization
Contact information
Practice address
1912 MEMORIAL AVE, LYNCHBURG, VA 24501-1708
(434) 845-8765
(434) 845-8467
Mailing address
1912 MEMORIAL AVE, LYNCHBURG, VA 24501-1708
(434) 845-8765
(434) 845-8467
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225400000X
Rehabilitation Practitioner
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004978757
—
VA
01
—
192595
ANTHEM PT
VA
01
—
192596
ANTHEM OT
VA
01
—
192597
ANTHEM ST
VA
05
—
QPA413
—
SC
Enumeration date
03/31/2006
Last updated
08/21/2024
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