Most Relevant Information
Provider Data
| NPI Number: | 1003483793 |
| Provider Name: | JOSH DWYER STAFFORD PTA |
| Entity Type: | Individual |
| Taxonomy Code: | 208100000X |
| Specialty: | Physical Medicine & Rehabilitation |
| License Number: | 2306604931 |
Most Important Dates
| Enumeration Date: | 06/10/2021 |
| Last Updated: | 06/10/2021 |
Provider Practice Location
12401 GAYTON RD
RICHMOND
VA
232382291
Practice Location Phone/Fax
| Phone: | 9194245078 |
| Fax: |
Provider Mailing Location
5816 PARK CRESTE DR
GLEN ALLEN
VA
230592605
Provider Mailing Phone/Fax
| Phone: | 8045439081 |
| Fax: |