COMMONWEALTH SPORTS MEDICINE PC NPI 1356406656

NPI Information

COMMONWEALTH SPORTS MEDICINE PC is a specialist in Glen Allen, VA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. COMMONWEALTH SPORTS MEDICINE PC NPI is 1356406656. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4300 POUNCEY TRACT RD
SUITE F
GLEN ALLEN, VA
ZIP 23060-007
Phone: (804) 270-7750
Fax: (804) 497-8625

The provider's authorized official is Teresa S Stadler .
The authorized official title is Owner and has the following contact phone number (804) 270-7750.

The enumeration date for this NPI number is 12/27/2006 and was last updated on 4/8/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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