Organization
ORTHOVIRGINIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TACARA LANE MA (CLINICAL SUPPORT SPECIALIST)
(804) 440-4878
Entity
Organization
Contact information
Practice address
12216 W BROAD ST # 45-B, HENRICO, VA 23233-1062
(804) 440-4878
(804) 200-7124
Mailing address
12216 W BROAD ST # 45-B, HENRICO, VA 23233-1062
(804) 440-4878
(804) 200-7124
Taxonomy
Speciality
Code
Description
License number
State
163WX0800X
Orthopedic Registered Nurse
Primary
—
—
Other
Enumeration date
11/19/2025
Last updated
11/19/2025
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