Healthcare Provider Details

I. General information

NPI: 1982918827
Provider Name (Legal Business Name): WILLIAMSBURG MOBILITY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2010
Last Update Date: 08/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

156 STRAWBERRY PLAINS RD SUITE D
WILLIAMSBURG VA
23188-3409
US

IV. Provider business mailing address

109 SHORE DRIVE
WILLIAMSBURG VA
23185
US

V. Phone/Fax

Practice location:
  • Phone: 757-645-4255
  • Fax:
Mailing address:
  • Phone: 757-645-4255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateVA

VIII. Authorized Official

Name: MR. RICHARD S BUNTING
Title or Position: OWNER
Credential:
Phone: 757-715-1481