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General NPI Number Information
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NPI Number | 1093523284
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Entity Type | Organization
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Legal Business Name | FAITH LOVE AND PT INC
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Dates
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Enumeration Date | 12/20/2024
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Last Update Date | 12/20/2024
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Provider Practice Location Address
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Address Line | 611 E MAIN ST
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City | DUBLIN
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State | VA
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Zip | 24084-3008
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Country | US
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Telephone | 540-440-1224
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Fax |
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Provider Business Mailing Address
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Address Line | 5207 COUNTRY MEADOW DR
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City | DUBLIN
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State | VA
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Zip | 24084-3811
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ELLEN MARSHALL
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Credential | DPT
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Telephone | 918-397-3119
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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