Individual
MS. AMY ELIZABETH FAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.P.T.
Contact information
Practice address
4818 MARKET SQUARE LN, MIDLOTHIAN, VA 23112-4826
(804) 744-3993
(804) 744-4301
Mailing address
5301 PROVIDENCE RD, SUITE 80, VIRGINIA BEACH, VA 23464-4128
(757) 467-1900
(757) 467-7900
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305204357
VA
Other
Enumeration date
05/17/2006
Last updated
01/07/2010
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