Provider Demographics
NPI:1073830444
Name:VIRGINIA UROLOGY CENTER PC
Entity Type:Organization
Organization Name:VIRGINIA UROLOGY CENTER PC
Other - Org Name:VIRGINIA UROLOGY PT
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:COFFEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-287-6101
Mailing Address - Street 1:9105 STONY POINT DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23235-1999
Mailing Address - Country:US
Mailing Address - Phone:804-287-6101
Mailing Address - Fax:804-288-3529
Practice Address - Street 1:9105 STONY POINT DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23235-1999
Practice Address - Country:US
Practice Address - Phone:804-287-6101
Practice Address - Fax:804-288-3529
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-26
Last Update Date:2010-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty