Individual
MR. JERRY ORRISON PUMPHREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
5300 HICKORY PARK DR, SUITE 110, GLEN ALLEN, VA 23059-2629
(804) 756-8495
(804) 270-7756
Mailing address
5300 HICKORY PARK DR, SUITE 110, GLEN ALLEN, VA 23059-2629
(804) 756-8495
(804) 270-7756
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305002651
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1760434948
GROUP PRACTICE NPI
VA
Enumeration date
05/16/2006
Last updated
05/09/2016
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