Provider Demographics
NPI:1154501559
Name:FLEENOR, ANN B (PT, CMT, NCTMB)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:B
Last Name:FLEENOR
Suffix:
Gender:F
Credentials:PT, CMT, NCTMB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:864 PANACELLA DR
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:VA
Mailing Address - Zip Code:24210-3943
Mailing Address - Country:US
Mailing Address - Phone:276-623-3413
Mailing Address - Fax:276-676-2269
Practice Address - Street 1:370 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:VA
Practice Address - Zip Code:24210-2906
Practice Address - Country:US
Practice Address - Phone:276-623-3413
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-14
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305202344225100000X
VA0019006156225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist