Provider Demographics
NPI:1871593988
Name:GOODBAR, ANNA MUSSELMAN (MPT)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:MUSSELMAN
Last Name:GOODBAR
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:25 CROSSING LN
Mailing Address - Street 2:SUITE 1
Mailing Address - City:LEXINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:24450-3724
Mailing Address - Country:US
Mailing Address - Phone:540-463-5888
Mailing Address - Fax:540-463-4406
Practice Address - Street 1:25 CROSSING LN
Practice Address - Street 2:SUITE 1
Practice Address - City:LEXINGTON
Practice Address - State:VA
Practice Address - Zip Code:24450-3724
Practice Address - Country:US
Practice Address - Phone:540-463-5888
Practice Address - Fax:540-463-4406
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2009-01-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA2305203721225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA266965OtherANTHEM
VA266965OtherANTHEM