Provider Demographics
NPI:1457798670
Name:LAW, NICHOLAS STEWART (DPT)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:STEWART
Last Name:LAW
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 BRENDA CT
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22901-2909
Mailing Address - Country:US
Mailing Address - Phone:434-872-1850
Mailing Address - Fax:
Practice Address - Street 1:2120 BERKMAR DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901-1424
Practice Address - Country:US
Practice Address - Phone:434-872-1850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-29
Last Update Date:2023-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305207922225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist