Provider Demographics
NPI:1578959656
Name:RHODES, WILLIAM BRUCE II (LPTA)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:BRUCE
Last Name:RHODES
Suffix:II
Gender:M
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1807 N PARHAM RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23229-4020
Mailing Address - Country:US
Mailing Address - Phone:804-477-3148
Mailing Address - Fax:
Practice Address - Street 1:1807 N PARHAM RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-4020
Practice Address - Country:US
Practice Address - Phone:804-477-3148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-15
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2306603800225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant