| NPI | 1811311343 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER BAILEY Credentialing Specialist 804-571-5106 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101034297) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0101036726) |
| 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: VA 0101226595) | |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: VA 0101231604) | |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: VA 0101237849) | |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: VA 0101045456) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: VA 0101052925) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: VA 0101222130) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: VA 0101235833) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: VA 0101224513) | |
| 213E00000X Podiatrist (Licence: VA 0103000995) | |
| 225100000X Physical Therapist (Licence: VA 2305005628) | |
| 225200000X Physical Therapy Assistant (Licence: VA 2306601247) | |
| 225XH1200X Occupational Therapist, Hand (Licence: VA 0119000261) | |
| 363A00000X Physician Assistant (Licence: VA 0110003073) | |
| Enumeration Date | 2014-02-04 |
| Last Update Date | 2019-06-11 |