Healthcare Provider Details

I. General information

NPI: 1093581399
Provider Name (Legal Business Name): LIVINGSPRING NEUROLOGY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2023
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

733 VOLVO PKWY
CHESAPEAKE VA
23320-1609
US

IV. Provider business mailing address

733 VOLVO PKWY
CHESAPEAKE VA
23320-1609
US

V. Phone/Fax

Practice location:
  • Phone: 209-426-9799
  • Fax: 844-689-9301
Mailing address:
  • Phone: 209-426-9799
  • Fax: 844-689-9301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License Number
License Number State

VIII. Authorized Official

Name: OLUBUSOLA HELEN AMIOLA
Title or Position: MANAGING MEMBER
Credential:
Phone: 757-347-4531