Provider Demographics
NPI:1760275721
Name:HARRIS, VICTORIA HOPE (DPT, PT)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:HOPE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2332 BAY BEACH CT
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54302-4742
Mailing Address - Country:US
Mailing Address - Phone:920-634-4898
Mailing Address - Fax:
Practice Address - Street 1:104 SANDERS AVE
Practice Address - Street 2:
Practice Address - City:CHILHOWIE
Practice Address - State:VA
Practice Address - Zip Code:24319-5999
Practice Address - Country:US
Practice Address - Phone:276-646-8774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-23
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305217140225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist