Provider Demographics
NPI:1063833218
Name:ABILITIES ABOUND PHYSICAL THERAPY AND WELLNESS CENTER PLLC
Entity Type:Organization
Organization Name:ABILITIES ABOUND PHYSICAL THERAPY AND WELLNESS CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MERTHIA
Authorized Official - Middle Name:I
Authorized Official - Last Name:HAYNIE
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:757-810-5574
Mailing Address - Street 1:PO BOX 197
Mailing Address - Street 2:
Mailing Address - City:CALLAO
Mailing Address - State:VA
Mailing Address - Zip Code:22435-0197
Mailing Address - Country:US
Mailing Address - Phone:804-529-5178
Mailing Address - Fax:
Practice Address - Street 1:765 NORTHUMBERLAND HWY
Practice Address - Street 2:
Practice Address - City:CALLAO
Practice Address - State:VA
Practice Address - Zip Code:22435-2206
Practice Address - Country:US
Practice Address - Phone:804-529-5179
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-13
Last Update Date:2014-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy