MEDICARE: RICHARD POYNER

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2305003555	OTHER	VA	LICENSE

General Provider Information

NPI Number	:	1598875221
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD POYNER

Provider Business Mailing Address
First Line	:	9130 DICKEY DR STE A
Second Line	:
City	:	MECHANICSVILLE
State	:	VA
Zip	:	23116-2502
Country	:	US
Telephone Number	:	804-723-5940
Fax Number	:	804-723-5949

Provider Business Practice Location Address
First Line	:	9130 DICKEY DR STE A
Second Line	:
City	:	MECHANICSVILLE
State	:	VA
Zip	:	23116-2502
Country	:	US
Telephone Number	:	804-723-5940
Fax Number	:	804-723-5949

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	05/24/2010

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Directions to “ RICHARD POYNER ” Practice Location

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