| |
1115 Boulders Pkwy, Suite 100a, North Chesterfield, VA 23225-4067 | |
(804) 330-8165 | |
(804) 330-5829 |
Full Name | |
---|---|
Type | Facility |
Speciality | Clinic/center - Multi-specialty |
Location | 1115 Boulders Pkwy, North Chesterfield, Virginia |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1154422939 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | (* (Not Available)) | Secondary |
261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
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Po Box 715868, Philadelphia, PA 19171-5868 Ph: (804) 915-1910 | 1115 Boulders Pkwy, Suite 100a, North Chesterfield, VA 23225-4067 Ph: (804) 330-8165 |