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General NPI Number Information
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NPI Number | 1376769083
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Entity Type | Individual
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Provider Name | JESSICA NADIG LOURA PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 04/18/2007
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Last Update Date | 11/06/2025
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Provider Practice Location Address
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Address Line | 3040 BERKMAR DR STE A1
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22901-1593
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Country | US
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Telephone | 434-979-8628
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Fax |
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Provider Business Mailing Address
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Address Line | 3040 BERKMAR DR STE A1
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22901-1593
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Country | US
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Telephone | 434-979-8628
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 2305204710
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License Number State | VA
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