Basic Information
| Provider Information | |||||||||
| NPI: | 1699040238 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STEADMAN | ||||||||
| FirstName: | CHARLES | ||||||||
| MiddleName: | BROOKS | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PHD, PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 545 SOUTHLAKE BLVD | ||||||||
| Address2: | |||||||||
| City: | NORTH CHESTERFIELD | ||||||||
| State: | VA | ||||||||
| PostalCode: | 232363042 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8043785010 | ||||||||
| FaxNumber: | 8043783264 | ||||||||
| Practice Location | |||||||||
| Address1: | 2000 BREMO RD | ||||||||
| Address2: | |||||||||
| City: | RICHMOND | ||||||||
| State: | VA | ||||||||
| PostalCode: | 232262440 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8043785010 | ||||||||
| FaxNumber: | 8043783264 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/15/2012 | ||||||||
| LastUpdateDate: | 03/19/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 2305207283 | VA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.