Provider Demographics
NPI:1215014196
Name:RPN OF VA INC
Entity Type:Organization
Organization Name:RPN OF VA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:TARVIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-972-1100
Mailing Address - Street 1:3301 BENSON DR
Mailing Address - Street 2:STE 135B
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-7362
Mailing Address - Country:US
Mailing Address - Phone:919-878-9996
Mailing Address - Fax:919-878-8871
Practice Address - Street 1:3301 BENSON DR
Practice Address - Street 2:SUITE 135 B
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-7362
Practice Address - Country:US
Practice Address - Phone:919-878-9996
Practice Address - Fax:919-878-8871
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-31
Last Update Date:2010-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy