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General NPI Number Information
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NPI Number | 1841834819
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Entity Type | Organization
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Legal Business Name | ORTHOVIRGINIA CARE MANAGEMENT LLC
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Dates
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Enumeration Date | 11/04/2019
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Last Update Date | 11/04/2019
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Provider Practice Location Address
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Address Line | 7858 SHRADER RD
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City | HENRICO
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State | VA
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Zip | 23294-4222
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Country | US
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Telephone | 804-560-5595
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Fax | 804-560-9029
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Provider Business Mailing Address
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Address Line | 1115 BOULDERS PKWY STE 200
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23225-4067
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Country | US
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Telephone | 804-915-4607
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Fax | 804-560-9029
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Authorized Official
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Title or Position | CEO
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Name | DALE INGRAM
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Credential |
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Telephone | 804-915-4600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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