Healthcare Provider Details

I. General information

NPI: 1093735003
Provider Name (Legal Business Name): MARK DAVID CHRONIS OTR/L, CBIS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 BROAD ROCK BLVD
RICHMOND VA
23249-0001
US

IV. Provider business mailing address

7730 PRAIRIE RD
RICHMOND VA
23225-1442
US

V. Phone/Fax

Practice location:
  • Phone: 804-675-5000
  • Fax: 804-675-5335
Mailing address:
  • Phone: 804-323-1997
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XN1300X
TaxonomyNeurorehabilitation Occupational Therapist
License Number10748
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: