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General NPI Number Information
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NPI Number | 1598417149
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Entity Type | Individual
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Provider Name | DEVIN POWELSON CFO, COA
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Gender | Female
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Dates
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Enumeration Date | 01/25/2022
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Last Update Date | 01/25/2022
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Provider Practice Location Address
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Address Line | 7301 FOREST AVE STE 202
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City | RICHMOND
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State | VA
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Zip | 23226-3792
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Country | US
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Telephone | 804-533-7272
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Fax | 804-418-3127
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Provider Business Mailing Address
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Address Line | 413 WALTHALL RIDGE DR
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City | SOUTH CHESTERFIELD
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State | VA
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Zip | 23834-6847
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Country | US
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Telephone | 804-405-9217
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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 | 225000000X
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Taxonomy Name | Orthotic Fitter
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License Number |
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License Number State |
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