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General NPI Number Information
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NPI Number | 1215380290
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Entity Type | Organization
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Legal Business Name | CENTER FOR WORK RECOVERY
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Dates
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Enumeration Date | 07/14/2016
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Last Update Date | 07/14/2016
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Provider Practice Location Address
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Address Line | 762 INDEPENDENCE BLVD SUITE # 772
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City | VIRGINIA BEACH
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State | VA
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Zip | 23455-6200
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Country | US
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Telephone | 757-481-6701
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Fax | 757-481-6175
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Provider Business Mailing Address
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Address Line | PO BOX 5982
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City | VIRGINIA BEACH
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State | VA
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Zip | 23471-0982
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Country | US
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Telephone | 757-481-6701
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Fax | 757-481-6175
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | ROBERT MAROON
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Credential |
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Telephone | 757-285-9797
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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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