Provider Demographics
NPI:1003094525
Name:VERTIGO DIZZY CLINIC LLC
Entity Type:Organization
Organization Name:VERTIGO DIZZY CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LUCIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LIPTAKOVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-229-4004
Mailing Address - Street 1:337 MCLAWS CIR
Mailing Address - Street 2:STE 3
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185-6334
Mailing Address - Country:US
Mailing Address - Phone:757-229-4004
Mailing Address - Fax:757-229-9992
Practice Address - Street 1:337 MCLAWS CIR
Practice Address - Street 2:STE 3
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-6334
Practice Address - Country:US
Practice Address - Phone:757-229-4004
Practice Address - Fax:757-229-9992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-06
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty