Organization
SPORT MEDICINE AND ORTHOPAEDIC CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RIANNON RUSCITTO (CREDENTIALING SPECIALIST)
(757) 842-7010
Entity
Organization
Contact information
Practice address
5801 HARBOUR VIEW BLVD STE 201, SUFFOLK, VA 23435-2657
(757) 842-7010
Mailing address
501 DISCOVERY DR, CHESAPEAKE, VA 23320-3843
(757) 842-7010
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
10/15/2021
Last updated
10/15/2021
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