Individual
HAVEN MASON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
1600 WESTBROOK AVE, RICHMOND, VA 23227-3337
(804) 264-6216
Mailing address
6115 ELLIS AVE, RICHMOND, VA 23228-5224
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306602951
VA
Other
Enumeration date
03/11/2013
Last updated
03/11/2013
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