Organization
FULL MOON PEDIATRIC THERAPY LLC
Active
Other names
Vaz Dhani Wilson LLC
Organization subpart
No
Provider details
NPI number
Authorized official
VESNEEK DHANI OTR/L (OWNER)
(804) 965-3797
Entity
Organization
Contact information
Practice address
1511 CARTER ST, RICHMOND, VA 23220-6903
(804) 965-3797
Mailing address
1511 CARTER ST, RICHMOND, VA 23220-6903
(804) 965-3797
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
07/28/2022
Last updated
01/18/2023
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