Provider Demographics
NPI:1386474914
Name:LEBEDKO, VICTORIA (DPT)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:LEBEDKO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:533 FRONT ST APT 247
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23510-1080
Mailing Address - Country:US
Mailing Address - Phone:585-967-8118
Mailing Address - Fax:
Practice Address - Street 1:1900 MONTICELLO AVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23517-2339
Practice Address - Country:US
Practice Address - Phone:757-742-3778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-07
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305216653225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist