Organization
ORTHOVIRGINIA, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE PROFFITT (CREDENTIALING & ENROLLMENT)
(804) 533-2357
Entity
Organization
Contact information
Practice address
1850 TOWN CENTER PARKWAY, SUITE 400, RESTON, VA 20190-2019
(703) 810-5202
Mailing address
PO BOX 715868, PHILADELPHIA, PA 19171-5868
(180) 491-5191
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
03/18/2022
Last updated
03/21/2022
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