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
13801 ST FRANCIS BOULEVARD, SUITE 200, MIDLOTHIAN, VA 23114-3206
(804) 270-1305
(804) 273-9294
Mailing address
PO BOX 715868, PHILADELPHIA, PA 19171-4067
(804) 915-1910
(804) 968-1803
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
—
VA
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
01/24/2017
Last updated
03/22/2022
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