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Organization
NOVA NEURO REHAB PLLC
Active
Organization
NOVA NEURO REHAB PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAMERON WAGGONER PT, DPT, NCS (OWNER/MANAGING MEMBER)
(901) 288-8063
Entity
Organization
Contact information
Practice address
400 MADISON ST APT 1406, ALEXANDRIA, VA 22314-1724
(901) 288-8063
Mailing address
PO BOX 25451, ALEXANDRIA, VA 22313-5451
(901) 288-8063
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
05/29/2024
Last updated
06/17/2024
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