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General NPI Number Information
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NPI Number | 1104923309
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Entity Type | Organization
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Legal Business Name | REACH FOR PERFORMANCE, INC.
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 04/04/2008
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Provider Practice Location Address
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Address Line | 312 LIGHTFOOT RD SUITE J
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City | WILLIAMSBURG
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State | VA
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Zip | 23188-9004
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Country | US
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Telephone | 757-258-1221
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Fax | 757-258-7733
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Provider Business Mailing Address
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Address Line | 312 LIGHTFOOT RD SUITE J
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City | WILLIAMSBURG
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State | VA
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Zip | 23188-9004
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Country | US
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Telephone | 757-258-1221
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Fax | 757-258-7733
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Authorized Official
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Title or Position | DIRECTOR
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Name | SHIELA M. ROBISON
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Credential | M.S.P.T
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Telephone | 757-258-1221
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number |
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License Number State | VA
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