Individual
FEGAN H. RICHMOND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
4831 S LABURNUM AVE, RICHMOND, VA 23231-2713
(804) 222-0745
(804) 222-0748
Mailing address
2122 YORK RD STE 300, OAK BROOK, IL 60523-1925
(630) 575-6200
(410) 648-4878
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305207510
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1235484197
—
VA
01
—
C05954
MEDICARE GROUP PTAN
VA
01
—
P01406467
MEDICARE RR PTAN
VA
Enumeration date
07/17/2012
Last updated
01/15/2025
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