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2552 Aldridge Ave, South Chesterfield, VA 23834-5306 | |
(804) 365-5898 | |
Not Available |
Full Name | |
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Type | Facility |
Speciality | Podiatrist |
Location | 2552 Aldridge Ave, South Chesterfield, Virginia |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1184101065 | NPI | - | NPPES |
0103301225 | Other | VA | VIRGINIA BOARD OF MEDICINE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
213E00000X | Podiatrist | 0103301225 (Virginia) | Primary |
Mailing Address | Practice Location Address |
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4704 Barrel Point Rd, Prince George, VA 23875-2976 Ph: (305) 206-7638 | 2552 Aldridge Ave, South Chesterfield, VA 23834-5306 Ph: (804) 365-5898 |