Organization
ORTHOVIRGINIA, INC
Active
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
15300 EAST WEST ROAD, MIDLOTHIAN, VA 23114
(804) 379-2414
(804) 379-2413
Mailing address
PO BOX 715868, PHILADELPHIA, PA 19171-5868
(804) 915-1910
(804) 379-2413
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
261QR0400X
Rehabilitation Clinic/Center
—
—
Other
Enumeration date
08/09/2024
Last updated
07/22/2025
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