MEDICARE: RADIUS PT OF VIRGINIA LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist
2	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1043982390
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RADIUS PT OF VIRGINIA LLC

Provider Business Mailing Address
First Line	:	563 UNIVERSITY BLVD STE 152
Second Line	:
City	:	HARRISONBURG
State	:	VA
Zip	:	22801-3752
Country	:	US
Telephone Number	:	540-534-1338
Fax Number	:	540-301-2773

Provider Business Practice Location Address
First Line	:	563 UNIVERSITY BLVD STE 152
Second Line	:
City	:	HARRISONBURG
State	:	VA
Zip	:	22801-3752
Country	:	US
Telephone Number	:	540-534-1338
Fax Number	:	540-301-2773

Authorized Official
Title or Position	:	DIRECTOR OF CORPORATE OPERATINS
Name	:	BRAD KEISLING
Credential	:
Telephone Number	:	843-441-0595

Provider Enumeration Date	:	10/04/2021
Last Update Date	:	08/16/2023

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