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Contact Information

SHAWN VAN DECKER, PTA, OPTA, CPT
611 WATKINS CENTRE PKWY
MIDLOTHIAN, VA23114-4404
 Phone: 804-325-8822
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Sports Medicine

2081S0010X 25 Physician/Physical Medicine and Rehabilitation
Indicates primary specialty

NPI Profile & details for SHAWN VAN DECKER · (Male)

NPI Number 1861032427
Status Active
Credentials PTA, OPTA, CPT
Entity Individual
Enumeration date 01/13/2020
Last updated 01/13/2020 - About 6 years ago
Sole proprietor 1 No
Identifiers
  • VA License # 2306603530
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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