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Organization

OLD DOMINION PHYSICAL MEDICINE PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TODD A WICHMAN M.D. (OWNER)
(804) 521-5310
Entity
Organization

Contact information

Practice address
5700 FITZHUGH AVE, HEALTHSOUTH REHABILITATION HOSPITAL, RICHMOND, VA 23226-1800
(804) 521-5310
Mailing address
3900 WESTERRE PKWY, SUITE 300, RICHMOND, VA 23233-1478
(804) 521-5310
(804) 477-1252

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
0101253471
VA

Other

Enumeration date
03/26/2015
Last updated
03/26/2015
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