Healthcare Provider Details

I. General information

NPI: 1467364844
Provider Name (Legal Business Name): RL SPICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5238 VALLEYPOINTE PKWY STE 1A
ROANOKE VA
24019-3066
US

IV. Provider business mailing address

5220 OAKMONT CIR
ROANOKE VA
24019-2632
US

V. Phone/Fax

Practice location:
  • Phone: 540-783-5291
  • Fax:
Mailing address:
  • Phone: 540-783-5291
  • Fax: 540-566-4679

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224L00000X
TaxonomyPedorthist
License Number
License Number State

VIII. Authorized Official

Name: MR. RICHARD SPICE
Title or Position: OWNER/FOUNDER
Credential: C.PED, CFO
Phone: 540-783-5291