Provider Demographics
NPI:1063824548
Name:PICARD, JAMES WILFRED III (PT, DPT)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:WILFRED
Last Name:PICARD
Suffix:III
Gender:M
Credentials:PT, DPT
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1305 SKIPWITH RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23229-5948
Mailing Address - Country:US
Mailing Address - Phone:804-517-6456
Mailing Address - Fax:
Practice Address - Street 1:5300 HICKORY PARK DR
Practice Address - Street 2:SUITE 110
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23059-2629
Practice Address - Country:US
Practice Address - Phone:804-270-7754
Practice Address - Fax:804-270-7756
Is Sole Proprietor?:No
Enumeration Date:2014-06-02
Last Update Date:2014-10-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA23052087422251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic