Healthcare Provider Details

I. General information

NPI: 1942911722
Provider Name (Legal Business Name): PRECISION THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2022
Last Update Date: 12/12/2022
Certification Date: 12/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 WYNDVIEW DR
LYNCHBURG VA
24502-2894
US

IV. Provider business mailing address

21430 TIMBERLAKE RD # 325
LYNCHBURG VA
24502-7248
US

V. Phone/Fax

Practice location:
  • Phone: 919-219-4729
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: MRS. LAUREN ROSS
Title or Position: OWNER/MANAGER
Credential: BCBA, LBA,
Phone: 919-219-4729