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Organization

ORTHOVIRGINIA, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
NICOLE PROFFITT (CREDENTIALING & ENROLLMENT)
(804) 533-2357
Entity
Organization

Contact information

Practice address
125 AKERS FARM RD STE C&D, CHRISTIANSBURG, VA 24073-4866
(540) 552-7133
Mailing address
PO BOX 715868, PHILADELPHIA, PA 19171-5868
(804) 915-1910
(804) 560-9029

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
208100000X
Physical Medicine & Rehabilitation Physician
261QM1300X
Multi-Specialty Clinic/Center
Primary

Other

Enumeration date
07/08/2019
Last updated
06/03/2022
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