Provider Demographics
NPI:1316768070
Name:CALKINS, PATRICIA (LPTA, LMT)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:CALKINS
Suffix:
Gender:F
Credentials:LPTA, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3103 EDGEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23222-2505
Mailing Address - Country:US
Mailing Address - Phone:757-726-3363
Mailing Address - Fax:
Practice Address - Street 1:2405 WESTWOOD AVE STE 107
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-4016
Practice Address - Country:US
Practice Address - Phone:804-404-6563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-24
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0019018595225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist