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Individual

MRS. CORA TYSON HUITT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA, PT

Contact information

Practice address
1919 HUGUENOT RD, SUITE 202, RICHMOND, VA 23235-4321
(804) 379-3002
(804) 379-3053
Mailing address
14 CLARKE RD, RICHMOND, VA 23226-1622
(804) 213-0082
(804) 213-0528

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305001184
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
192292
ANTHEM PROVIDER NUMBER
VA
01
2305001184
PHYSICAL THERAPY LICENSE
VA
Enumeration date
09/06/2006
Last updated
08/30/2007
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