Provider Demographics
NPI:1871201046
Name:MATHEWS, LIBBY (DPT)
Entity type:Individual
Prefix:
First Name:LIBBY
Middle Name:
Last Name:MATHEWS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:LIBBY
Other - Middle Name:
Other - Last Name:THOMASON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:25298 LEE HWY
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:VA
Mailing Address - Zip Code:24211-7460
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:25298 LEE HWY
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:VA
Practice Address - Zip Code:24211-7460
Practice Address - Country:US
Practice Address - Phone:276-698-3104
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-07
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305215479225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist