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General NPI Number Information
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NPI Number | 1578058632
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Entity Type | Organization
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Legal Business Name | CHARLOTTESVILLE PT PLUS, LLC
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Dates
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Enumeration Date | 06/29/2018
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Last Update Date | 06/29/2018
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Provider Practice Location Address
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Address Line | 1924 ARLINGTON BLVD STE 100
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22903-1533
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Country | US
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Telephone | 434-984-0303
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Fax |
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Provider Business Mailing Address
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Address Line | 1924 ARLINGTON BLVD STE 100
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22903-1533
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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 | OWNER, SOLE MEMBER
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Name | LAURA COLEMAN
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Credential | PT
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Telephone | 434-242-8077
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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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