Provider Demographics
NPI:1720503683
Name:EASTER, DOROTHY MARIE (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:DOROTHY
Middle Name:MARIE
Last Name:EASTER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2170 CLOVERLEAF LN
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:VA
Mailing Address - Zip Code:22821-2636
Mailing Address - Country:US
Mailing Address - Phone:540-493-9736
Mailing Address - Fax:
Practice Address - Street 1:302 N 2ND ST
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:VA
Practice Address - Zip Code:22812-1712
Practice Address - Country:US
Practice Address - Phone:540-828-2550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-11
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305211303225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist