Healthcare Provider Details

I. General information

NPI: 1164590709
Provider Name (Legal Business Name): WILLIAM U ROODMAN DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2006
Last Update Date: 12/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3536 GROVE AVE
RICHMOND VA
23221-2200
US

IV. Provider business mailing address

3536 GROVE AVE
RICHMOND VA
23221-2200
US

V. Phone/Fax

Practice location:
  • Phone: 804-359-1768
  • Fax: 804-359-8344
Mailing address:
  • Phone: 804-673-9355
  • Fax: 804-359-8344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number541760584
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: