Provider Demographics
NPI:1073074845
Name:WHOLE MOTION THERAPY AND WELLNESS, PLLC
Entity Type:Organization
Organization Name:WHOLE MOTION THERAPY AND WELLNESS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:MIRELES PT, DPT
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:703-718-5909
Mailing Address - Street 1:12816 VALLEYHILL ST
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-6419
Mailing Address - Country:US
Mailing Address - Phone:703-718-5909
Mailing Address - Fax:
Practice Address - Street 1:12816 VALLEYHILL ST
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-6419
Practice Address - Country:US
Practice Address - Phone:703-718-5909
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-26
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty