Individual
JOSH DWYER STAFFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
12401 GAYTON RD, RICHMOND, VA 23238-2291
(919) 424-5078
Mailing address
5816 PARK CRESTE DR, GLEN ALLEN, VA 23059-2605
(804) 543-9081
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
2306604931
VA
Other
Enumeration date
06/10/2021
Last updated
06/10/2021
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