Organization
KING WILLIAM PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIMOTHY WAYNE MCDANIEL P.T. (OWNER)
(804) 769-7504
Entity
Organization
Contact information
Practice address
5983 RICHMOND TAPPAHANNOCK HWY, AYLETT, VA 23009-3009
(804) 769-7504
(804) 769-7524
Mailing address
5983 RICHMOND TAPPAHANNOCK HWY, AYLETT, VA 23009-3009
(804) 769-7504
(804) 769-7524
Taxonomy
Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
S094294-8
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010029686
—
VA
Enumeration date
12/17/2007
Last updated
02/22/2023
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