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General NPI Number Information
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NPI Number | 1447649165
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Entity Type | Organization
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Legal Business Name | VIRGINIA MOBILE WOUND CARE PHYSICIANS LLC
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Dates
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Enumeration Date | 01/19/2015
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Last Update Date | 04/03/2015
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Provider Practice Location Address
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Address Line | 14512 STANDING OAK CT
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City | MIDLOTHIAN
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State | VA
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Zip | 23112-6214
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Country | US
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Telephone | 718-669-6867
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Fax |
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Provider Business Mailing Address
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Address Line | 14512 STANDING OAK CT
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City | MIDLOTHIAN
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State | VA
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Zip | 23112-6214
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DPM
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Name | NORRIS MORRISON
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Credential |
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Telephone | 718-669-6867
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 0116022798
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License Number State | VA
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