Individual provider · NPI-1

Jarrod Sampson Basham, LPTA, BS

Physical Therapy Assistant · Richmond, VA

NPI number1760879209
StatusActive
Last updated in NPPESNov 22, 2019

Details

NPI
1760879209
Entity type
Individual (NPI-1)
Name
Mr. Jarrod Sampson Basham
Credential
LPTA, BS
Sex
Male
Sole proprietor
No
Enumeration date
Apr 22, 2015
Last updated
Nov 22, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225200000X Physical Therapy Assistant2306603933VAYes

Practice location

8900 Three Chopt Rd
Richmond, VA 23229-4615

Phone 804-288-0033 · Fax 804-288-0035

Mailing address

8900 Three Chopt Rd
Richmond, VA 23229-4615

Phone 804-288-0033 · Fax 804-288-0035

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