Gary Lee Allen

Individual provider Active NPI Physical Rehabilitation Occupational Therapist · Bristol, VA

NPI 1831964246 · NPPES record last updated Nov 16, 2023

Key facts

NPI
1831964246
Entity type
Individual (NPI type 1)
Primary specialty
Physical Rehabilitation Occupational Therapist 225XP0019X
License
818 (TN)
Practice address
245 North St
Bristol, VA 24201-3274
Phone
(276) 669-4711
NPI assigned
Nov 16, 2023
Sex
Male
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

LicenseStateTypeSpecialty
818TNMDAthletic Trainer

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Rehabilitation Occupational Therapist 225XP0019X 818 TN Yes

Addresses

Primary practice location

245 North St
Bristol, VA 24201-3274

Mailing address

1012 Pennsylvania Ave
Bristol, TN 37620-3829
Phone (423) 488-7207

Other providers in Bristol, VA

All providers in Bristol, VA · Physical Rehabilitation Occupational Therapist in Virginia

Sources for this page

Verify at the official NPI Registry.