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General NPI Number Information
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NPI Number | 1437847514
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Entity Type | Organization
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Legal Business Name | BACK TO MOTION PHYSICAL THERAPY, PLLC
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Dates
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Enumeration Date | 04/27/2023
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Last Update Date | 04/27/2023
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Provider Practice Location Address
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Address Line | 8304 WHISTLER RD
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City | RICHMOND
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State | VA
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Zip | 23227-1529
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Country | US
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Telephone | 321-356-8642
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Fax |
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Provider Business Mailing Address
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Address Line | 8304 WHISTLER RD
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City | RICHMOND
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State | VA
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Zip | 23227-1529
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Country | US
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Telephone | 321-356-8642
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CODY PROSSER
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Credential | DPT
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Telephone | 321-356-8642
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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