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Venu Gopal Divya

NPI 1336643857 · on the registry since 2018

Practice

Address
41465 Speckled Alder Ct
Aldie, VA 20105
Phone
(267) 275-1219
Organisation at this address
Star Rehab Llc
Inferred from a shared address, not stated in the registry.

Registry record

Primary taxonomy
225100000X
225100000X
Licence states on file
VA
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2024-05-03

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Virginia