Individual
MR. MICHAEL JAMES RAVEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPTA
Contact information
Practice address
7246 FOREST HILL AVE, RICHMOND, VA 23225-1524
(804) 320-7901
Mailing address
9506 BENT WOOD LN, NORTH CHESTERFIELD, VA 23237-3262
(315) 854-0547
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306604708
VA
Other
Enumeration date
10/18/2017
Last updated
10/31/2017
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