Healthcare Provider Details

I. General information

NPI: 1750504833
Provider Name (Legal Business Name): RAPPAHANNOCK RAPIDAN CSB
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2007
Last Update Date: 09/16/2020
Certification Date: 09/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15361 BRADFORD RD
CULPEPER VA
22701-4238
US

IV. Provider business mailing address

PO BOX 1568
CULPEPER VA
22701-6568
US

V. Phone/Fax

Practice location:
  • Phone: 540-825-3100
  • Fax: 540-825-6245
Mailing address:
  • Phone: 540-825-3100
  • Fax: 540-825-6245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number4978374
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: JAMES LAGRAFFE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 540-825-3100