Individual
ANDREW TATOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
44 CLIFTON ST, LYNCHBURG, VA 24501-1422
(434) 528-1848
(434) 845-6748
Mailing address
20311 TIMBERLAKE RD, STE B, LYNCHBURG, VA 24502-7203
(434) 845-9053
(434) 528-2788
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305002168
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
650010545
MEDICARE RAILROAD
VA
05
—
9405313
—
VA
Enumeration date
08/05/2006
Last updated
11/18/2016
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