Organization
WOODORW WILSON REHABILITATION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD LUCK ED.D (DIRECTOR)
(540) 332-7451
Entity
Organization
Contact information
Practice address
243 WOODROW WILSON AVE, FISHERSVILLE, VA 22939
(540) 332-7087
Mailing address
PO BOX 1500, BOX W-1, FISHERSVILLE, VA 22939-1500
(540) 332-7087
Taxonomy
Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
192957
ANTHEM ST PROVIDER #
VA
Enumeration date
09/27/2006
Last updated
08/22/2020
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