Individual
MR. MIKE L SHORT SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1201 BROAD ROCK BLVD, RICHMOND, VA 23249
(804) 675-5000
Mailing address
1201 BROAD ROCK BLVD, RICHMOND, VA 23249
(804) 675-5000
Taxonomy
Speciality
Code
Description
License number
State
227900000X
Registered Respiratory Therapist
Primary
0117001881
VA
Other
Enumeration date
06/26/2023
Last updated
06/26/2023
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