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Individual

ANGELA LESTOURGEON PARKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, PT

Contact information

Practice address
7650 E PARHAM RD, SUITE 100, RICHMOND, VA 23294-4373
(804) 282-6338
(804) 285-3237
Mailing address
1115 BOULDERS PKWY, SUITE 200, NORTH CHESTERFIELD, VA 23225-4067
(804) 560-5595
(804) 560-9029

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305203317
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
008953104
VA
01
P00761610
RR MEDICARE
VA
Enumeration date
06/14/2006
Last updated
02/04/2014
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