Organization
BLACKSTONE PHYSICAL THERAPY LLC
Active
Organization
BLACKSTONE PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM H GOLD (PRACTICE MANAGER)
(434) 292-4167
Entity
Organization
Contact information
Practice address
930 SOUTH MAIN ST, BLACKSTONE, VA 23824-2614
(434) 292-4167
(434) 292-7554
Mailing address
PO BOX 238, BLACKSTONE, VA 23824-0238
(434) 292-4167
(434) 292-7554
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305002622
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
196190
ANTHEM
VA
Enumeration date
03/30/2007
Last updated
01/04/2008
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