Provider Demographics
NPI:1386632792
Name:MASSIE, DENISE L (PT)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:L
Last Name:MASSIE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1729 N SHENANDOAH AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:FRONT ROYAL
Mailing Address - State:VA
Mailing Address - Zip Code:22630-3643
Mailing Address - Country:US
Mailing Address - Phone:540-636-6179
Mailing Address - Fax:540-636-8753
Practice Address - Street 1:3127 VALLEY AVENUE
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-2635
Practice Address - Country:US
Practice Address - Phone:540-667-1800
Practice Address - Fax:540-667-3839
Is Sole Proprietor?:No
Enumeration Date:2005-10-10
Last Update Date:2017-04-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA2305006767225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA00V897P02Medicare PIN