Organization
ORTHOVIRGINIA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE PROFFITT (CREDENTIALING AND ENROLLMENT)
(804) 533-2357
Entity
Organization
Contact information
Practice address
12216 W BROAD STREET, SUITE 4B-5, HENRICO, VA 23233-1602
(804) 440-4878
(804) 200-7124
Mailing address
PO BOX 715868, PHILADELPHIA, PA 19171-5868
(804) 915-1910
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
10/17/2022
Last updated
10/17/2022
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