Healthcare Provider Details

I. General information

NPI: 1407311384
Provider Name (Legal Business Name): SURGICAL HANDS ON,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2019
Last Update Date: 02/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7028 PINE ORCHARD CT
CHESTERFIELD VA
23832-6665
US

IV. Provider business mailing address

PO BOX 611
CHESTERFIELD VA
23832-0009
US

V. Phone/Fax

Practice location:
  • Phone: 804-301-1927
  • Fax:
Mailing address:
  • Phone: 804-301-1927
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number
License Number State

VIII. Authorized Official

Name: MARTINA WASHINGTON
Title or Position: SURGICAL ASSISTANT
Credential: SURGICAL ASSISTANT
Phone: 804-301-1927