MEDICARE: VIRDIO, INC.

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
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1659081545
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VIRDIO, INC.

Provider Business Mailing Address
First Line	:	3228 NEBRASKA AVE
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90404-4214
Country	:	US
Telephone Number	:	202-701-6822
Fax Number	:

Provider Business Practice Location Address
First Line	:	3228 NEBRASKA AVE
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90404-4214
Country	:	US
Telephone Number	:	202-701-6822
Fax Number	:

Authorized Official
Title or Position	:	CHIEF EVANGELIST
Name	:	RONALD BRENT PLATT
Credential	:
Telephone Number	:	202-701-6822

Provider Enumeration Date	:	12/01/2022
Last Update Date	:	12/01/2022

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Directions to “VIRDIO, INC. ” Practice Location

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