Healthcare Provider Details

I. General information

NPI: 1023017472
Provider Name (Legal Business Name): MOBILE PHYSICAL THERAPY, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3604 MILBRANCH PL
RICHMOND VA
23233-7634
US

IV. Provider business mailing address

3604 MILBRANCH PL
RICHMOND VA
23233-7634
US

V. Phone/Fax

Practice location:
  • Phone: 804-726-2340
  • Fax: 804-726-2341
Mailing address:
  • Phone: 804-726-2340
  • Fax: 804-726-2341

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305202101
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number2305202101
License Number StateVA

VIII. Authorized Official

Name: SAMUEL PAUL LAWSON
Title or Position: PRESIDENT
Credential: PT MS OCS
Phone: 804-726-2340