| NPI | 1770699456 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ISAAC ROSS Manager 757-595-4880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225XH1200X Occupational Therapist, Hand (Licence: VA 0119000085) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: VA 0119000085) |
| 225XH1200X Occupational Therapist, Hand (Licence: VA 0119002028) | |
| 225XN1300X Occupational Therapist, Neurorehabilitation (Licence: VA 0119002028) | |
| 225XP0200X Occupational Therapist, Pediatrics (Licence: VA 0119002028) | |
| 335E00000X Prosthetic/Orthotic Supplier (Licence: VA 0119002028) | |
| 335E00000X Prosthetic/Orthotic Supplier (Licence: VA 0119000085) | |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2021-03-04 |