Organization
MOSHER PHYSICAL THERAPY & SPORTS MEDICINE PC
Active
Organization
MOSHER PHYSICAL THERAPY & SPORTS MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RUSSELL A MOSHER MSPT (PRESIDENT OWNER)
(757) 789-3075
Entity
Organization
Contact information
Practice address
712 RANDOLPH AVE, CAPE CHARLES, VA 23310-3308
(757) 331-4490
(757) 331-4491
Mailing address
PO BOX 1059, ONLEY, VA 23418-1059
(757) 331-4490
(757) 331-4491
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
5088
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
147224
ANTHEM BCBS
VA
Enumeration date
12/22/2005
Last updated
08/22/2020
Update your record
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