Lydia Blevins
Individual provider Active NPI Physical Therapy Assistant · Beckley, WV
NPI 1215545264 · NPPES record last updated Jul 15, 2020
Key facts
- NPI
- 1215545264
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 001607 (WV)
- Practice address
- 405 Stanaford Rd
Beckley, WV 25801-3143 - Phone
- (304) 252-6317
- NPI assigned
- Jul 15, 2020
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001607 | WV | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 001607 | WV | Yes |
Addresses
Primary practice location
405 Stanaford Rd
Beckley, WV 25801-3143
Mailing address
149 Maplewood Rd
Lester, WV 25865-9580
Other providers in Beckley, WV
- Brent Bledsoe
- Kathleen Bledsoe
- Andrea Blevins
- Jaxsyn Ryker Blevins
- Kayla Blevins
- Shannon Blevins
- Thomas Blevins
- Blueridge Clinic PLLC
- Bluestone Counseling LLC
- Robin A Blume
All providers in Beckley, WV · Physical Therapy Assistant in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 15, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.