MEDICARE: VIRGINIA ENS

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
1	225100000X	Physical Therapist	2305210345	VA

General Provider Information

NPI Number	:	1811340748
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIRGINIA ENS

Provider Business Mailing Address
First Line	:	2110 MARINA SHORES DR APT 420
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23451-6855
Country	:	US
Telephone Number	:	540-421-7116
Fax Number	:

Provider Business Practice Location Address
First Line	:	2110 MARINA SHORES DR APT 420
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23451-6855
Country	:	US
Telephone Number	:	540-421-7116
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/15/2016
Last Update Date	:	12/02/2025

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Directions to “ VIRGINIA ENS ” Practice Location

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