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NPI Code Detail

MEDICARE: RICHELLE COVER PT

MEDICARE: RICHELLE COVER PT
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 Therapist2305204157VA

General Provider Information

NPI Number : 1417078007
Entity Type Code : Individual
Provider Name (Legal Business Name) : RICHELLE COVER PT
Provider Business Mailing Address
First Line : 245 CHESAPEAKE AVE
Second Line :
City : NEWPORT NEWS
State : VA
Zip : 23607-6038
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 245 CHESAPEAKE AVE
Second Line :
City : NEWPORT NEWS
State : VA
Zip : 23607-6038
Country : US
Telephone Number : 757-928-8050
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/02/2007
Last Update Date : 04/03/2013

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Directions to “ RICHELLE COVER PT” Practice Location

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