Organization
ORTHOVIRGINIA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE PROFFITT (CREDENTIALING AND ENROLLMENT)
(804) 533-2357
Entity
Organization
Contact information
Practice address
1760 OLD MEADOW RD STE 205, MC LEAN, VA 22102-4330
(703) 810-5214
(703) 810-5475
Mailing address
PO BOX 715868, PHILADELPHIA, PA 19171-5868
(804) 915-1910
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
10/08/2020
Last updated
06/03/2022
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