Individual
RASIDAT TAIWO SHOGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1645 HIGH PLAINS DR, VIRGINIA BEACH, VA 23464-8508
(862) 235-9631
Mailing address
1645 HIGH PLAINS DR, VIRGINIA BEACH, VA 23464-8508
(862) 235-9631
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306604768
VA
Other
Enumeration date
10/10/2017
Last updated
10/10/2017
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