Healthcare Provider Details

I. General information

NPI: 1598602732
Provider Name (Legal Business Name): LAYLA BOOTH LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

538 MAIN ST
CLIFTON FORGE VA
24422
US

IV. Provider business mailing address

4404 JOHNSON CREEK RD
COVINGTON VA
24426-5438
US

V. Phone/Fax

Practice location:
  • Phone: 540-521-6167
  • Fax:
Mailing address:
  • Phone: 540-521-6167
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number0019019970
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: