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Search › Virginia › 224Z00000X

Shannon Polivka, COTA

NPI 1992301790 · on the registry since 2020

Practice

Address
11 Dairy Ln
Fredericksburg, VA 22405
Phone
(540) 371-9414
Organisation at this address
11 Dairy Lane Opco, Llc
11 Dairy Lane Operations Llc
Genesis Eldercare National Centers, Inc.
Genesis Eldercare Physician Services Llc
Genesis Eldercare Physician Services I Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
37

Registry record

Primary taxonomy
224Z00000X
224Z00000X
Licence states on file
VA
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2020-12-07

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