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NPI Code Detail

MEDICARE: ADDISON LANG

MEDICARE: ADDISON LANG
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
1225100000XPhysical Therapist2305215115VA

General Provider Information

NPI Number : 1700517521
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADDISON LANG
Provider Business Mailing Address
First Line : 350 NEW FIDELITY CT
Second Line :
City : GARNER
State : NC
Zip : 27529-2665
Country : US
Telephone Number : 919-373-2919
Fax Number : 410-648-4878
Provider Business Practice Location Address
First Line : 9 MANHATTAN SQ STE B
Second Line :
City : HAMPTON
State : VA
Zip : 23666-6263
Country : US
Telephone Number : 757-825-3400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2022
Last Update Date : 07/20/2022

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Directions to “ ADDISON LANG ” Practice Location

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