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NPI Code Detail

MEDICARE: KAREN WORTH ROYALL DPT

MEDICARE: KAREN WORTH ROYALL DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist2305002708VA

General Provider Information

NPI Number : 1265455570
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAREN WORTH ROYALL DPT
Provider Business Mailing Address
First Line : 218 51ST ST
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23451-2428
Country : US
Telephone Number : 757-647-5107
Fax Number :
Provider Business Practice Location Address
First Line : 1400 FORDHAM DR
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23464-5368
Country : US
Telephone Number : 757-361-3951
Fax Number : 757-361-3957
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2006
Last Update Date : 08/15/2014

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