Old Dominion Physical Medicine PLLC
Physical Medicine & Rehabilitation in Richmond, VA. Organization (NPI-2).
NPI number1508250697
StatusActive
Last updated in NPPESMar 26, 2015
Details
- NPI
- 1508250697
- Entity type
- Organization (NPI-2)
- Legal business name
- Old Dominion Physical Medicine PLLC
- Organization subpart
- No
- Enumeration date
- Mar 26, 2015
- Last updated
- Mar 26, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208100000X | Physical Medicine & Rehabilitation | 0101253471 | VA | Yes |
Practice location
5700 Fitzhugh AveHealthsouth Rehabilitation Hospital
Richmond, VA 23226-1800
Phone 804-521-5310
Mailing address
3900 Westerre PkwySuite 300
Richmond, VA 23233-1478
Phone 804-521-5310 · Fax 804-477-1252
Authorized official
Todd A Wichman
Owner
8045215310
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