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General NPI Number Information
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NPI Number | 1457162984
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Entity Type | Organization
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Legal Business Name | DELTA PHYSIO AND WELLNESS SERVICES PLLC
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Dates
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Enumeration Date | 01/15/2025
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Last Update Date | 01/15/2025
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Provider Practice Location Address
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Address Line | 1512 HELMSDALE DR
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City | RICHMOND
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State | VA
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Zip | 23238-4722
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Country | US
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Telephone | 302-757-1818
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Fax |
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Provider Business Mailing Address
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Address Line | 10509 PATTERSON AVE # PO29111
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City | HENRICO
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State | VA
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Zip | 23242-1251
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Country | US
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Telephone | 302-757-1818
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JACK GERLITZ
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Credential |
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Telephone | 302-757-1818
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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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Taxonomy #2
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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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