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General NPI Number Information
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NPI Number | 1285645127
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Entity Type | Individual
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Provider Name | ALICE ELAINE RAJA P.T.
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Gender | Female
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Dates
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Enumeration Date | 08/09/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 200 MEDICAL PKWY SUITE 210
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City | CHESAPEAKE
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State | VA
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Zip | 23320-4911
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Country | US
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Telephone | 757-436-6913
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Fax | 757-547-2544
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Provider Business Mailing Address
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Address Line | 200 MEDICAL PKWY SUITE 210
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City | CHESAPEAKE
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State | VA
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Zip | 23320-4911
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Country | US
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Telephone | 757-436-6913
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Fax | 757-547-2544
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 2305002939
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License Number State | VA
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