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General NPI Number Information
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NPI Number | 1023987740
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Entity Type | Organization
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Legal Business Name | ORTHOVIRGINIA, INC
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Dates
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Enumeration Date | 10/31/2025
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Last Update Date | 10/31/2025
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Provider Practice Location Address
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Address Line | 2090 PRINCESS ANNE RD STE 140
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City | VIRGINIA BEACH
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State | VA
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Zip | 23456-4095
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Country | US
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Telephone | 804-320-1339
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Fax |
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Provider Business Mailing Address
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Address Line | 1115 BOULDERS PKWY
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23225-4067
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Country | US
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Telephone | 804-320-1339
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Fax |
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Authorized Official
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Title or Position | PROVIDER ENROLLMENT MANAGER
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Name | ERICA TYLER
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Credential |
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Telephone | 804-528-1548
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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