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5317 Lakeside Ave Ste A, Henrico, VA 23228-6007 | |
(804) 303-4961 | |
Not Available |
Full Name | |
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Type | Facility |
Speciality | Health Maintenance Organization |
Location | 5317 Lakeside Ave Ste A, Henrico, Virginia |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1144627670 | NPI | - | NPPES |
Provider Name | Nelson Fisher Gregory |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1972502250 PECOS PAC ID: 1355240706 Enrollment ID: I20040105000493 |
Provider Name | Peter R Allen |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1912139874 PECOS PAC ID: 5395882187 Enrollment ID: I20091027000884 |
Provider Name | Ellen O'keefe |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1922244946 PECOS PAC ID: 0345599965 Enrollment ID: I20180815001608 |
Mailing Address | Practice Location Address |
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5317 Lakeside Ave Ste A, Henrico, VA 23228-6007 Ph: (804) 303-4961 | 5317 Lakeside Ave Ste A, Henrico, VA 23228-6007 Ph: (804) 303-4961 |