Individual
MRS. ELIZABETH ANN MEDWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSOTR/L
Contact information
Practice address
1849 OLD DONATION PKWY, VIRGINIA BEACH, VA 23454-3004
(757) 422-8476
(757) 425-8476
Mailing address
1849 OLD DONATION PKWY, VIRGINIA BEACH, VA 23454-3004
(757) 422-8476
(757) 425-8476
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
0119006070
VA
225XH1200X
Hand Occupational Therapist
Primary
0119006070
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C05501
MEDICARE GROUP
VA
Enumeration date
04/20/2016
Last updated
01/22/2020
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