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General NPI Number Information
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NPI Number | 1679167282
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Entity Type | Organization
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Legal Business Name | REJ RICHMOND INC
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Dates
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Enumeration Date | 02/24/2021
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Last Update Date | 02/24/2021
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Provider Practice Location Address
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Address Line | 7301 FOREST AVE STE 200
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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 | 414-736-1317
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Fax |
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Provider Business Mailing Address
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Address Line | 15255 WATERTOWN PLANK RD STE 200
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City | ELM GROVE
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State | WI
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Zip | 53122-2338
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Country | US
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Telephone | 414-736-1317
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | RICHARD SALINAS
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Credential |
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Telephone | 414-736-1317
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RS0010X
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Taxonomy Name | Sports Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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