Organization
DOMINION HEALTH & FITNESS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BERNARD P. DHAS P.T. (DIRECTOR)
(276) 926-4516
Entity
Organization
Contact information
Practice address
4862 DICKENSON HWY, CLINTWOOD, VA 24228-1810
(276) 926-4516
(276) 926-6652
Mailing address
PO BOX 1810, CLINTWOOD, VA 24228-1810
(276) 926-4516
(276) 926-6652
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225200000X
Physical Therapy Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010193885
—
VA
01
—
1201827
CHA HEALTH PROVIDER #
VA
01
—
196257
ANTHEM GROUP PROVIDER #
VA
01
—
3782625
AETNA HEALTHCARE #
VA
Enumeration date
07/20/2006
Last updated
05/16/2011
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