Healthcare Provider Details

I. General information

NPI: 1417866153
Provider Name (Legal Business Name): VERSA WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1702 E ARLINGTON BLVD STE B
GREENVILLE NC
27858-7843
US

IV. Provider business mailing address

PO BOX 6
SIMPSON NC
27879-0006
US

V. Phone/Fax

Practice location:
  • Phone: 252-295-8649
  • Fax:
Mailing address:
  • Phone: 252-295-8649
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: VICTORIA JARVIS
Title or Position: OWNER
Credential: PT, DPT
Phone: 252-295-8649