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General NPI Number Information
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NPI Number | 1144519885
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Entity Type | Organization
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Legal Business Name | VIRGINIA PROFESSIONAL HEARING HEALTHCARE CENTER
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Dates
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Enumeration Date | 04/04/2011
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Last Update Date | 04/04/2011
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Provider Practice Location Address
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Address Line | 620 MOOREFIELD PARK DR SUITE 100
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City | RICHMOND
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State | VA
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Zip | 23236
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Country | US
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Telephone | 804-330-1350
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Fax |
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Provider Business Mailing Address
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Address Line | 620 MOOREFIELD PARK DR SUITE 100
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City | RICHMOND
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State | VA
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Zip | 23236-3692
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Country | US
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Telephone | 804-330-1350
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHANTELL D LEWIS
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Credential |
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Telephone | 804-330-1350
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number |
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License Number State |
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