Healthcare Provider Details

I. General information

NPI: 1356465249
Provider Name (Legal Business Name): ROBIN PERDUE WADKINS LPTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/18/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 CEDARFIELD PKWY
RICHMOND VA
23233-1936
US

IV. Provider business mailing address

7732 MARILEA RD
RICHMOND VA
23225-1122
US

V. Phone/Fax

Practice location:
  • Phone: 804-474-8844
  • Fax: 804-290-0038
Mailing address:
  • Phone: 804-330-8742
  • Fax: 804-330-8741

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number2306000785
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: