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NPI Code Detail

MEDICARE: CENTER FOR NEUROREHABILITATION SERVICES

MEDICARE: CENTER FOR NEUROREHABILITATION SERVICES
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
12084P0301XBrain Injury Medicine (Psychiatry & Neurology) Physician0101036956VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1350504800OTHERVADOL PROVIDER NUMBER

General Provider Information

NPI Number : 1275672073
Entity Type Code : Organization
Provider Name (Legal Business Name) : CENTER FOR NEUROREHABILITATION SERVICES
Provider Business Mailing Address
First Line : 7401 BEAUFONT SPRINGS DR
Second Line : SUITE 205
City : NORTH CHESTERFIELD
State : VA
Zip : 23225-5520
Country : US
Telephone Number : 804-272-0114
Fax Number : 804-272-1125
Provider Business Practice Location Address
First Line : 7401 BEAUFONT SPRINGS DR
Second Line : SUITE 205
City : NORTH CHESTERFIELD
State : VA
Zip : 23225-5520
Country : US
Telephone Number : 804-272-0114
Fax Number : 804-272-1125
Authorized Official
Title or Position : ADMINISTRATOR
Name : MR. VAN WILLIAM LUETHKE
Credential :
Telephone Number : 804-272-0114
Provider Enumeration Date : 02/06/2007
Last Update Date : 05/11/2023

Similar Medicare Providers

1144234337 — MRS. REBECCA M SMITH A.N.P.
Practice Location Address:
7401 BEAUFONT SPRINGS DR , SUITE 100
NORTH CHESTERFIELD, VA
23225-5520
Practice Phone: 804-323-5011
Practice Fax: 804-323-5120
1487803730 — CHRISTOPHER ANDERSON LPT
Practice Location Address:
7401 BEAUFONT SPRINGS DR
NORTH CHESTERFIELD, VA
23225-5520
Practice Phone: 804-272-0114
Practice Fax: 804-272-1125
1326401084 — JENNIFER ZNOTENS M,A., CCC-SLP
Practice Location Address:
7401 BEAUFONT SPRING DR , SUITE 205
NORTH CHESTERFIELD, VA
23225-5520
Practice Phone: 804-272-0114
Practice Fax: 804-272-1125
1376578765 — DR. JOHN MARK DIGRAZIA M.D.
Practice Location Address:
7401 BEAUFONT SPRINGS DR , SUITE 100
RICHMOND, VA
23225-5520
Practice Phone: 804-323-5011
Practice Fax: 804-323-5120
1053334094 — YVONNE JACKSON WEAVER M.D.
Practice Location Address:
7401 BEAUFONT SPRINGS DR , SUITE 100
RICHMOND, VA
23225-5520
Practice Phone: 804-323-5011
Practice Fax: 804-323-5120
1891888749 — MRS. NICOLE LINN WALKER MPT
Practice Location Address:
5520 NORTH EAGLE ROAD , SUITE 102
BOISE, ID
83713-0998
Practice Phone: 208-938-5255
Practice Fax: 208-938-5545

Directions to “CENTER FOR NEUROREHABILITATION SERVICES ” Practice Location

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