Organization
SPORT MEDICINE AND ORTHOPAEDIC CENTER INC
Active
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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