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General NPI Number Information
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NPI Number | 1578728788
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Entity Type | Organization
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Legal Business Name | PILATES CENTRAL LLC
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Dates
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Enumeration Date | 07/28/2008
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Last Update Date | 07/28/2008
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Provider Practice Location Address
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Address Line | 401 GRANBY ST
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City | NORFOLK
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State | VA
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Zip | 23510-1913
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Country | US
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Telephone | 757-464-3000
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Fax | 757-965-2432
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Provider Business Mailing Address
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Address Line | PO BOX 68076
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City | VIRGINIA BEACH
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State | VA
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Zip | 23471-8076
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Country | US
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Telephone | 757-464-3000
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Fax | 757-965-2432
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MRS. MARY E LOUMEAU
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Credential |
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Telephone | 757-464-3000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 2305006240
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License Number State | VA
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