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General NPI Number Information
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NPI Number | 1073074845
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Entity Type | Organization
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Legal Business Name | WHOLE MOTION THERAPY AND WELLNESS, PLLC
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Dates
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Enumeration Date | 03/26/2019
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Last Update Date | 01/11/2021
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Provider Practice Location Address
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Address Line | 12816 VALLEYHILL ST
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City | WOODBRIDGE
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State | VA
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Zip | 22192-6419
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Country | US
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Telephone | 703-718-5909
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Fax |
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Provider Business Mailing Address
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Address Line | 12816 VALLEYHILL ST
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City | WOODBRIDGE
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State | VA
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Zip | 22192-6419
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Country | US
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Telephone | 703-718-5909
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Fax |
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Authorized Official
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Title or Position | OWNER / PHYSICAL THERAPIST
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Name | DR. MARLENE MIRELES PT, DPT
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Credential | PT, DPT
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Telephone | 703-718-5909
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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