Provider Demographics
NPI:1699040238
Name:STEADMAN, CHARLES BROOKS (PHD, PT)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:BROOKS
Last Name:STEADMAN
Suffix:
Gender:M
Credentials:PHD, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:545 SOUTHLAKE BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23236-3042
Mailing Address - Country:US
Mailing Address - Phone:804-378-5010
Mailing Address - Fax:804-378-3264
Practice Address - Street 1:2000 BREMO RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-2440
Practice Address - Country:US
Practice Address - Phone:804-378-5010
Practice Address - Fax:804-378-3264
Is Sole Proprietor?:No
Enumeration Date:2012-03-15
Last Update Date:2012-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305207283225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist