Provider Demographics
NPI:1578629150
Name:FAY, DORI LYNNE (PT)
Entity type:Individual
Prefix:MRS
First Name:DORI
Middle Name:LYNNE
Last Name:FAY
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 1:3761 ASHLEIGH WAY RD
Mailing Address - Street 2:
Mailing Address - City:BARBOURSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22923-2011
Mailing Address - Country:US
Mailing Address - Phone:434-978-4487
Mailing Address - Fax:
Practice Address - Street 1:500 GREENBRIER DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901-1682
Practice Address - Country:US
Practice Address - Phone:434-975-5079
Practice Address - Fax:434-975-9079
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2008-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27685225100000X
VA2305205193225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist