Provider Demographics
NPI:1043982390
Name:RADIUS PT OF VIRGINIA LLC
Entity Type:Organization
Organization Name:RADIUS PT OF VIRGINIA LLC
Other - Org Name:LEGACY PT OF VIRGINIA LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DIRECTOR OF CORPORATE OPERATINS
Authorized Official - Prefix:
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:
Authorized Official - Last Name:KEISLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-441-0595
Mailing Address - Street 1:563 UNIVERSITY BLVD STE 152
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-3752
Mailing Address - Country:US
Mailing Address - Phone:540-534-1338
Mailing Address - Fax:540-301-2773
Practice Address - Street 1:563 UNIVERSITY BLVD STE 152
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-3752
Practice Address - Country:US
Practice Address - Phone:540-534-1338
Practice Address - Fax:540-301-2773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-04
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty