Healthcare Provider Details
I. General information
NPI: 1083268197
Provider Name (Legal Business Name): VIRGINIA PROSTHETICS INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/26/2019
Last Update Date: 11/23/2021
Certification Date: 11/23/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10710 MIDLOTHIAN TPKE STE 116
NORTH CHESTERFIELD VA
23235-4766
US
IV. Provider business mailing address
4338 WILLIAMSON RD NW
ROANOKE VA
24012-2893
US
V. Phone/Fax
- Phone: 888-366-8287
- Fax:
- Phone: 540-366-8287
- Fax: 352-872-5433
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 224P00000X |
| Taxonomy | Prosthetist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
JAMES
DOUGLAS
CALL
Title or Position: PRESIDENT
Credential:
Phone: 540-366-8287