Provider Demographics
NPI:1093387748
Name:ATLANTIC KNEE RESTORATION & REGENERATIVE MEDICINE - RICHMOND
Entity Type:Organization
Organization Name:ATLANTIC KNEE RESTORATION & REGENERATIVE MEDICINE - RICHMOND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:TREY
Authorized Official - Last Name:CRITTENDEN
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:256-302-2228
Mailing Address - Street 1:7481 RIGHT FLANK RD STE 100
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23116-3838
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7481 RIGHT FLANK RD STE 100
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23116-3838
Practice Address - Country:US
Practice Address - Phone:256-302-2228
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-13
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty