Provider Demographics
NPI:1225273626
Name:ONSITE PHYSICAL THERAPY AND CONSULTANTS, INC.
Entity Type:Organization
Organization Name:ONSITE PHYSICAL THERAPY AND CONSULTANTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:LERON
Authorized Official - Last Name:EDMONDS
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:757-971-3464
Mailing Address - Street 1:5308 RIVER EDGE RD
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-3509
Mailing Address - Country:US
Mailing Address - Phone:757-971-3464
Mailing Address - Fax:757-423-8298
Practice Address - Street 1:5308 RIVER EDGE RD
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-3509
Practice Address - Country:US
Practice Address - Phone:757-971-3464
Practice Address - Fax:757-423-8298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-13
Last Update Date:2011-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171WH0202X, 253Z00000X
VA2305202617225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive Care
No171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty