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General NPI Number Information
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NPI Number | 1578291480
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Entity Type | Individual
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Provider Name | NATHAN WILLIAM NUTTING
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Gender | Male
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Dates
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Enumeration Date | 08/09/2022
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Last Update Date | 08/09/2022
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Provider Practice Location Address
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Address Line | 8266 ATLEE RD STE 224
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City | MECHANICSVILLE
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State | VA
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Zip | 23116-1813
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Country | US
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Telephone | 804-454-7240
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Fax |
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Provider Business Mailing Address
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Address Line | 915 E 4TH ST APT 324
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City | RICHMOND
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State | VA
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Zip | 23224-5506
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Country | US
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Telephone | 360-466-8402
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Fax |
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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 | 2305215277
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License Number State | VA
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