Provider Demographics
NPI:1093102410
Name:ORTHOPEDIC INSTITUTE OF VIRGINIA PLLC
Entity Type:Organization
Organization Name:ORTHOPEDIC INSTITUTE OF VIRGINIA PLLC
Other - Org Name:ADVANCED ORTHOPAEDICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:R
Authorized Official - Last Name:ZASLAV
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:804-270-1305
Mailing Address - Street 1:7858 SHRADER RD
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23294-4222
Mailing Address - Country:US
Mailing Address - Phone:804-270-1305
Mailing Address - Fax:804-273-9294
Practice Address - Street 1:13801 ST FRANCIS BLVD
Practice Address - Street 2:200
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23114-3206
Practice Address - Country:US
Practice Address - Phone:804-270-1305
Practice Address - Fax:804-273-9294
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ORTHOPEDIC INSTITUTE OF VIRGINIA PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-04-23
Last Update Date:2015-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies