IndividualActive
Shawn Van Decker, PTA, OPTA, CPT
NPI 1861032427 · Sports Medicine (Physical Medicine & Rehabilitation) Physician · Midlothian, VA
Provider details
- NPI number
- 1861032427
- Entity type
- Individual
- Primary specialty
- Sports Medicine (Physical Medicine & Rehabilitation) PhysicianAllopathic & Osteopathic Physicians
- Credential
- PTA, OPTA, CPT
- Sex
- Male
- Sole proprietor
- No
- License
- 2306603530 (VA)
Specialties & taxonomies
- Sports Medicine (Physical Medicine & Rehabilitation) PhysicianPrimary2081S0010XLicense 2306603530 (VA)
Allopathic & Osteopathic Physicians
Practice location
611 Watkins Centre Pkwy
Midlothian, VA 23114-4404
Phone: (804) 325-8822
Approximate (ZIP-level) locationGet directions
Mailing address
611 Watkins Centre Pkwy
Midlothian, VA 23114-4404
Registry dates
- Enumerated
- 2020-01-13
- Last updated
- 2020-01-13
- Certified
- 2020-01-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.