Orthovirginia INC
Clinic/Center, Multi-Specialty in Chesapeake, VA. Organization (NPI-2).
NPI number1003554445
StatusActive
Last updated in NPPESAug 17, 2023
Details
- NPI
- 1003554445
- Entity type
- Organization (NPI-2)
- Legal business name
- Orthovirginia INC
- Organization subpart
- No
- Enumeration date
- May 25, 2022
- Certification date
- Aug 17, 2023
- Last updated
- Aug 17, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM1300X | Clinic/Center, Multi-Specialty | – | – | Yes |
| 261QP2000X | Clinic/Center, Physical Therapy | – | – | |
| 261QR0401X | Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) | – | – |
Practice location
667 Kingsborough SquareSuite 300
Chesapeake, VA 23320-4999
Phone 757-422-8476 · Fax 804-435-2172
Mailing address
Po Box 715868Philadelphia, PA 19171-5868
Phone 804-915-1910 · Fax 804-968-1803
Authorized official
Nicole Proffitt
Credentialing & Enrollment
8045332357
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