Provider Demographics
NPI:1316443336
Name:WHITLOCK, RHEA AMBER (PT)
Entity type:Individual
Prefix:DR
First Name:RHEA
Middle Name:AMBER
Last Name:WHITLOCK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2809 ABBEY LN
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23233-1607
Mailing Address - Country:US
Mailing Address - Phone:540-295-3663
Mailing Address - Fax:
Practice Address - Street 1:615 EAST ST
Practice Address - Street 2:
Practice Address - City:BLACKSTONE
Practice Address - State:VA
Practice Address - Zip Code:23824-2231
Practice Address - Country:US
Practice Address - Phone:434-292-5300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-30
Last Update Date:2018-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA23052047032251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics