Individual
ALEXANDER TRACEY SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3920 SPRINGFIELD RD, GLEN ALLEN, VA 23060-4119
(804) 747-7472
Mailing address
3920 SPRINGFIELD RD, GLEN ALLEN, VA 23060-4119
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305208156
VA
Other
Enumeration date
08/09/2013
Last updated
08/09/2013
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