Provider Demographics
NPI:1932306388
Name:ABILITY PHYSICAL MEDICINE AND REHABILITATION INC
Entity Type:Organization
Organization Name:ABILITY PHYSICAL MEDICINE AND REHABILITATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:L
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:540-951-9000
Mailing Address - Street 1:3706 S MAIN ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:BLACKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24060-7006
Mailing Address - Country:US
Mailing Address - Phone:540-951-9000
Mailing Address - Fax:540-951-7799
Practice Address - Street 1:3706 S MAIN ST
Practice Address - Street 2:SUITE A
Practice Address - City:BLACKSBURG
Practice Address - State:VA
Practice Address - Zip Code:24060-7006
Practice Address - Country:US
Practice Address - Phone:540-951-9000
Practice Address - Fax:540-951-7799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101058886174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty