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General NPI Number Information
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NPI Number | 1841470606
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Entity Type | Organization
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Legal Business Name | OPEQUON REHABILITATION & WELLNESS, PC
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Dates
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Enumeration Date | 11/09/2007
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Last Update Date | 05/16/2008
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Provider Practice Location Address
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Address Line | 3107 VALLEY AVE SUITE 108
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City | WINCHESTER
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State | VA
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Zip | 22601-2675
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Country | US
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Telephone | 540-535-2228
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Fax | 540-535-2204
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Provider Business Mailing Address
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Address Line | 3107 VALLEY AVE SUITE 108
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City | WINCHESTER
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State | VA
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Zip | 22601-2675
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Country | US
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Telephone | 540-535-2228
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Fax | 540-535-2204
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. DAVID SHELBY SIMS JR.
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Credential | PT
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Telephone | 540-535-2228
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 2305003951
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License Number State | VA
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