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NPI Code Detail

MEDICARE: MISS VIRGINIA JOY NICHOLSON MPT

MEDICARE: MISS VIRGINIA JOY NICHOLSON MPT
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 Therapist2305203779VA

General Provider Information

NPI Number : 1316154552
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS VIRGINIA JOY NICHOLSON MPT
Provider Business Mailing Address
First Line : 1316 VICTORIAN VILLAGE DR
Second Line :
City : HARRISONBURG
State : VA
Zip : 22802-4671
Country : US
Telephone Number : 540-434-2122
Fax Number :
Provider Business Practice Location Address
First Line : 315 E LEE HWY
Second Line :
City : NEW MARKET
State : VA
Zip : 22844-3103
Country : US
Telephone Number : 540-740-8041
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2007
Last Update Date : 07/08/2007

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