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General NPI Number Information
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NPI Number | 1851781769
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Entity Type | Organization
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Legal Business Name | RVA PHYSICAL THERAPY& SPORTS REHAB, LLC
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Dates
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Enumeration Date | 01/29/2015
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Last Update Date | 01/25/2022
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Provider Practice Location Address
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Address Line | 2620 GASKINS RD STE A
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City | HENRICO
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State | VA
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Zip | 23238-1402
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Country | US
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Telephone | 804-396-6753
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Fax |
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Provider Business Mailing Address
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Address Line | 2620 GASKINS RD STE A
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City | HENRICO
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State | VA
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Zip | 23238-1402
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Country | US
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Telephone | 804-396-6753
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Fax | 888-815-8184
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Authorized Official
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Title or Position | OWNER
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Name | MR. RAMAKRISHNAN KAVASERRY
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Credential | DPT
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Telephone | 804-874-2476
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number | 2305204964
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License Number State | VA
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