Provider Demographics
NPI:1194877761
Name:BRISTOL THERAPY SERVICES LLC
Entity type:Organization
Organization Name:BRISTOL THERAPY SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BETTY
Authorized Official - Middle Name:H
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:276-645-0311
Mailing Address - Street 1:3130 LEE HIGHWAY
Mailing Address - Street 2:SUITE 210
Mailing Address - City:BRISTOL
Mailing Address - State:VA
Mailing Address - Zip Code:24202-5943
Mailing Address - Country:US
Mailing Address - Phone:276-645-0311
Mailing Address - Fax:276-645-0302
Practice Address - Street 1:3130 LEE HIGHWAY
Practice Address - Street 2:SUITE 210
Practice Address - City:BRISTOL
Practice Address - State:VA
Practice Address - Zip Code:24202-5943
Practice Address - Country:US
Practice Address - Phone:276-645-0311
Practice Address - Fax:276-645-0302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA7195849OtherAETNA
VAVA0100OtherUHC OF RIVER VALLEY
VA700683OtherUHC-ACN
VA010259053Medicaid
VA193497OtherANTHEM
VA193497OtherANTHEM