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General NPI Number Information
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NPI Number | 1780959221
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Entity Type | Organization
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Legal Business Name | ORTHO PAIN RELIEF
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Dates
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Enumeration Date | 03/16/2012
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Last Update Date | 03/16/2012
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Provider Practice Location Address
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Address Line | 6802 PARAGON PL SUITE 410
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City | RICHMOND
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State | VA
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Zip | 23230-1644
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Country | US
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Telephone | 239-281-3356
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Fax | 239-362-2272
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Provider Business Mailing Address
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Address Line | 6802 PARAGON PL SUITE 410
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City | RICHMOND
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State | VA
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Zip | 23230-1644
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Country | US
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Telephone | 239-281-3356
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Fax | 239-362-2272
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Authorized Official
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Title or Position | OWNER
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Name | MR. WILLIAM HENRY PIERCE III
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Credential | LPTA
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Telephone | 239-281-3356
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 0206009663
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License Number State | VA
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