Provider Demographics
NPI:1497878227
Name:GIACOFEI, CARRIE CHEELEY (ATC)
Entity Type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:CHEELEY
Last Name:GIACOFEI
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:MS
Other - First Name:CARRIE
Other - Middle Name:SUSAN
Other - Last Name:CHEELEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC
Mailing Address - Street 1:3108 OSBORNE RD
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23831
Mailing Address - Country:US
Mailing Address - Phone:804-399-9611
Mailing Address - Fax:
Practice Address - Street 1:1115 BOULDERS PKWY SUITE 110
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23225
Practice Address - Country:US
Practice Address - Phone:804-560-6500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-08
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01260008692255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer