Provider Demographics
NPI:1518936459
Name:RICHMOND PHYSICAL THERAPY CORP
Entity Type:Organization
Organization Name:RICHMOND PHYSICAL THERAPY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARKOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-340-1193
Mailing Address - Street 1:3805 CUTSHAW AVE
Mailing Address - Street 2:STE 299
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230
Mailing Address - Country:US
Mailing Address - Phone:804-340-1193
Mailing Address - Fax:804-340-1930
Practice Address - Street 1:3805 CUTSHAW AVE
Practice Address - Street 2:STE 299
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230
Practice Address - Country:US
Practice Address - Phone:804-340-1193
Practice Address - Fax:804-340-1930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-14
Last Update Date:2009-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA2377654OtherAETNA
VADA5252OtherRAILROAD MEDICARE
VA6400713OtherUNITED HEALTHCARE
VA192056OtherANTHEM
VA279527OtherSOUTHERN HEALTH
VA6400713OtherUNITED HEALTHCARE