Provider Demographics
NPI:1154573327
Name:METZLER, DEREK SCOTT (PT)
Entity type:Individual
Prefix:MR
First Name:DEREK
Middle Name:SCOTT
Last Name:METZLER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 N 23RD ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23223-7101
Mailing Address - Country:US
Mailing Address - Phone:804-513-8813
Mailing Address - Fax:804-644-1223
Practice Address - Street 1:411 N 23RD ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23223-7101
Practice Address - Country:US
Practice Address - Phone:804-644-1221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-18
Last Update Date:2014-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305203246225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist