Provider Demographics
NPI:1326585621
Name:ROCHOW, ALICE BOYD (PA-C)
Entity Type:Individual
Prefix:
First Name:ALICE
Middle Name:BOYD
Last Name:ROCHOW
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 FEDERAL ST
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24504-2306
Mailing Address - Country:US
Mailing Address - Phone:256-783-6658
Mailing Address - Fax:
Practice Address - Street 1:320 FEDERAL ST
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24504-2306
Practice Address - Country:US
Practice Address - Phone:434-947-5967
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-24
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110005710363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant