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NPI Code Detail

MEDICARE: JESSICA NADIG LOURA PT, DPT

MEDICARE: JESSICA NADIG LOURA PT, DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QP2000XPhysical Therapy Clinic/Center2305204710VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1376769083
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA NADIG LOURA PT, DPT
Provider Business Mailing Address
First Line : 3040 BERKMAR DR STE A1
Second Line :
City : CHARLOTTESVILLE
State : VA
Zip : 22901-1593
Country : US
Telephone Number : 434-979-8628
Fax Number :
Provider Business Practice Location Address
First Line : 3040 BERKMAR DR STE A1
Second Line :
City : CHARLOTTESVILLE
State : VA
Zip : 22901-1593
Country : US
Telephone Number : 434-979-8628
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/18/2007
Last Update Date : 11/06/2025

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Directions to “ JESSICA NADIG LOURA PT, DPT” Practice Location

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