Healthcare Provider Details

I. General information

NPI: 1386693372
Provider Name (Legal Business Name): VIRGINIA ANNE MAY PT, MS, PCS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2006
Last Update Date: 06/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4560 SOUTH BLVD SUITE 310
VIRGINIA BEACH VA
23452-1160
US

IV. Provider business mailing address

1300 E OCEAN VIEW AVE UNIT D
NORFOLK VA
23503-2200
US

V. Phone/Fax

Practice location:
  • Phone: 757-490-3223
  • Fax:
Mailing address:
  • Phone: 757-480-4113
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number2305003422
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: