Provider Demographics
NPI:1043400385
Name:PT PLUS HEALTH, LLC
Entity Type:Organization
Organization Name:PT PLUS HEALTH, LLC
Other - Org Name:PT PLUS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:F
Authorized Official - Last Name:COLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:434-823-7628
Mailing Address - Street 1:5690 THREE NOTCHED RD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:CROZET
Mailing Address - State:VA
Mailing Address - Zip Code:22932-3172
Mailing Address - Country:US
Mailing Address - Phone:434-823-7628
Mailing Address - Fax:434-823-7681
Practice Address - Street 1:5690 THREE NOTCHED RD
Practice Address - Street 2:SUITE 107
Practice Address - City:CROZET
Practice Address - State:VA
Practice Address - Zip Code:22932-3172
Practice Address - Country:US
Practice Address - Phone:434-823-7628
Practice Address - Fax:434-823-7681
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-01
Last Update Date:2008-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305003158225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC10309Medicare PIN