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General NPI Number Information
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NPI Number | 1063264521
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Entity Type | Organization
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Legal Business Name | RESTORATIVE REHAB THERAPY SERVICES
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Dates
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Enumeration Date | 04/05/2024
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Last Update Date | 04/05/2024
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Provider Practice Location Address
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Address Line | 15601 CHESDIN LANDING TER
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City | CHESTERFIELD
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State | VA
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Zip | 23838-3242
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Country | US
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Telephone | 843-743-5819
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Fax | 804-324-4615
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Provider Business Mailing Address
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Address Line | 15601 CHESDIN LANDING TER
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City | CHESTERFIELD
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State | VA
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Zip | 23838-3242
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Country | US
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Telephone | 843-743-5819
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | ELINDRA COLEMAN-JOHNSON
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Credential |
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Telephone | 843-743-5819
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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