Healthcare Provider Details

I. General information

NPI: 1548254634
Provider Name (Legal Business Name): SENIOR JOURNEYS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1543 BEECH GROVE RD
ROSELAND VA
22967-2211
US

IV. Provider business mailing address

804 AFTON MOUNTAIN RD
AFTON VA
22920-2408
US

V. Phone/Fax

Practice location:
  • Phone: 434-361-2650
  • Fax: 434-361-2511
Mailing address:
  • Phone: 434-361-2650
  • Fax: 434-361-2511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateVA

VIII. Authorized Official

Name: MS. AGNES FUJIE SCHRIDER
Title or Position: PHYSICAL THERAPIST OWNER
Credential: PT
Phone: 434-361-2650