| NPI | 1740820851 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE PROFFITT Credentialing/Enrollment 804-533-2357 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery |
| 261QP2000X Clinic/Center, Physical Therapy | |
| 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) | |
| 261QX0100X Clinic/Center, Occupational Medicine | |
| Enumeration Date | 2020-01-07 |
| Last Update Date | 2023-08-17 |