Organization
ONWARD RICHMOND, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK J GALLANT DPT (OWNER/OPERATOR)
(757) 509-9748
Entity
Organization
Contact information
Practice address
312 BROOK RD, RICHMOND, VA 23220-4225
(804) 655-6327
Mailing address
4910 ROSEWELL DR, GLOUCESTER, VA 23061-3629
(757) 509-9748
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2305207513
PT LICENSE
VA
Enumeration date
02/11/2021
Last updated
02/11/2021
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