Scott Richardson

Individual provider Active NPI Physical Therapy Assistant · Axton, VA

NPI 1407265689 · NPPES record last updated Aug 12, 2014

Key facts

NPI
1407265689
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
2306603912 (VA)
Practice address
113 Linnies CT
Axton, VA 24054-1729
Phone
(276) 806-6278
NPI assigned
Aug 12, 2014
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2306603912VAMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2306603912 VA Yes

Addresses

Primary practice location

113 Linnies CT
Axton, VA 24054-1729

Mailing address

113 Linnies CT
Axton, VA 24054-1729
Phone (276) 806-6278

Other providers in Axton, VA

All providers in Axton, VA · Physical Therapy Assistant in Virginia

Sources for this page

Verify at the official NPI Registry.