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Organization

FEDSERVE HAMPTON ROADS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DANIEL ODUKOYA (OWNER)
(301) 841-5077
Entity
Organization

Contact information

Practice address
901 HAMPTON BLVD STE 302, NORFOLK, VA 23507-1503
(301) 841-5077
Mailing address
4789 CHEROKEE ST, COLLEGE PARK, MD 20740-1816
(301) 841-5077

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
261QP2000X
Physical Therapy Clinic/Center

Other

Enumeration date
01/28/2026
Last updated
01/28/2026
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