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General NPI Number Information
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NPI Number | 1598646648
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Entity Type | Organization
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Legal Business Name | INTERVENTIONAL ORTHOPEDIC & CONCUSSION CLINIC
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Dates
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Enumeration Date | 09/08/2025
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Last Update Date | 09/08/2025
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Provider Practice Location Address
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Address Line | 12901 BRIGGS RD SUITE 201
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City | CHESTER
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State | VA
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Zip | 23831-5335
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Country | US
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Telephone | 804-821-2140
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Fax |
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Provider Business Mailing Address
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Address Line | 12901 BRIGGS RD SUITE 201
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City | CHESTER
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State | VA
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Zip | 23831-5335
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Country | US
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Telephone | 804-821-2140
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Fax |
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Authorized Official
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Title or Position | MEDICAL BILLING MANAGER
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Name | ALLISON LEWIS
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Credential |
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Telephone | 804-715-4709
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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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 | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number |
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License Number State |
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