Provider Demographics
NPI:1336203025
Name:DIANNE D. EPPLEIN, R.P.T & ASSOCIATES, PC
Entity type:Organization
Organization Name:DIANNE D. EPPLEIN, R.P.T & ASSOCIATES, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANNE
Authorized Official - Middle Name:D
Authorized Official - Last Name:EPPLEIN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:757-473-8016
Mailing Address - Street 1:818 NEWTOWN RD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-1116
Mailing Address - Country:US
Mailing Address - Phone:757-473-8016
Mailing Address - Fax:757-473-3580
Practice Address - Street 1:818 NEWTOWN RD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-1116
Practice Address - Country:US
Practice Address - Phone:757-473-8016
Practice Address - Fax:757-473-3580
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No335E00000XSuppliersProsthetic/Orthotic SupplierGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA004980093Medicaid
VA4980093OtherVIRGINA PREMEIR HEALTH PL
VA007328OtherANTHEM-BLUE CROSS
VA350034OtherOPTIMA HEALTH PLAN
VA9116460Medicaid
VA004980093Medicaid
VA007328OtherANTHEM-BLUE CROSS