Healthcare Provider Details

I. General information

NPI: 1629239496
Provider Name (Legal Business Name): ORTHOPEDIC PHYSICAL THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2008
Last Update Date: 06/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10442 RIDGEFIELD PKWY
RICHMOND VA
23233-3544
US

IV. Provider business mailing address

10442 RIDGEFIELD PKWY
RICHMOND VA
23233-3544
US

V. Phone/Fax

Practice location:
  • Phone: 804-285-0148
  • Fax:
Mailing address:
  • Phone: 804-285-0148
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number089240000
License Number StateVA

VIII. Authorized Official

Name: MS. TRACEY K ADLER
Title or Position: PRESIDENT OWNER
Credential: MS PT OCS
Phone: 804-285-0148