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General NPI Number Information
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NPI Number | 1841704400
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Entity Type | Individual
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Provider Name | TAMEKA CHANTE WITCHER
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Gender | Female
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Dates
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Enumeration Date | 11/18/2017
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Last Update Date | 11/18/2017
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Provider Practice Location Address
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Address Line | 7246 FOREST HILL AVE
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City | RICHMOND
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State | VA
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Zip | 23225-1524
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Country | US
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Telephone | 804-320-7901
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Fax |
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Provider Business Mailing Address
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Address Line | 227 CARROLLTON RD
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City | DANVILLE
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State | VA
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Zip | 24540-3323
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Country | US
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Telephone |
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 2306604942
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License Number State | VA
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