Provider Demographics
NPI:1194882498
Name:AMERICAN ORTHOPEDIC AND REHABILITATION ASSOCIATION PC
Entity type:Organization
Organization Name:AMERICAN ORTHOPEDIC AND REHABILITATION ASSOCIATION PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MERVET
Authorized Official - Middle Name:H
Authorized Official - Last Name:EL ASSAL MAXIMOUS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:434-774-2500
Mailing Address - Street 1:PO BOX 456
Mailing Address - Street 2:
Mailing Address - City:BRACEY
Mailing Address - State:VA
Mailing Address - Zip Code:23919-0456
Mailing Address - Country:US
Mailing Address - Phone:434-774-2500
Mailing Address - Fax:434-447-4704
Practice Address - Street 1:416 DURANT ST
Practice Address - Street 2:
Practice Address - City:SOUTH HILL
Practice Address - State:VA
Practice Address - Zip Code:23970-1614
Practice Address - Country:US
Practice Address - Phone:434-774-2500
Practice Address - Fax:434-447-4704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty