Organization
ORTHOVIRGINIA, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE PROFFITT (CREDENTIALING/ENROLLMENT)
(804) 533-2357
Entity
Organization
Contact information
Practice address
1400 JOHNSTON WILLIS DR, SUITE B, NORTH CHESTERFIELD, VA 23235-4765
(804) 379-3840
(804) 379-9567
Mailing address
PO BOX 715868, PHILADELPHIA, PA 19171-5868
(804) 915-1910
(804) 560-9029
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
12/13/2006
Last updated
06/03/2022
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