Provider Demographics
NPI:1417260209
Name:MVPT, LLC
Entity Type:Organization
Organization Name:MVPT, LLC
Other - Org Name:MIDLOTHIAN VILLAGE PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:BRANDON
Authorized Official - Last Name:REAM
Authorized Official - Suffix:
Authorized Official - Credentials:MPT, CSCS
Authorized Official - Phone:804-464-2323
Mailing Address - Street 1:14265 MIDLOTHIAN TPKE
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113-6560
Mailing Address - Country:US
Mailing Address - Phone:804-464-2323
Mailing Address - Fax:804-464-2323
Practice Address - Street 1:14265 MIDLOTHIAN TPKE
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113-6560
Practice Address - Country:US
Practice Address - Phone:804-464-2323
Practice Address - Fax:804-464-2323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-21
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305202156261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy