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
15195 HEATHCOTE BOULEVARD, SUITE 334, HAYMARKET, VA 20169-6244
(703) 369-9070
(703) 810-5302
Mailing address
PO BOX 715868, PHILADELPHIA, PA 19171-5868
(804) 915-1910
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
03/08/2023
Last updated
03/08/2023
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