Provider Demographics
NPI:1164726352
Name:WOODLAND THERAPY & WELLNESS CENTER LLC
Entity Type:Organization
Organization Name:WOODLAND THERAPY & WELLNESS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / CEO
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:C
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-392-6106
Mailing Address - Street 1:2003 COBB ST
Mailing Address - Street 2:
Mailing Address - City:FARMVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23901-2603
Mailing Address - Country:US
Mailing Address - Phone:434-392-6106
Mailing Address - Fax:434-392-4736
Practice Address - Street 1:2003 COBB ST
Practice Address - Street 2:
Practice Address - City:FARMVILLE
Practice Address - State:VA
Practice Address - Zip Code:23901-2603
Practice Address - Country:US
Practice Address - Phone:434-392-6106
Practice Address - Fax:434-392-4736
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE WOODLAND INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-01-02
Last Update Date:2011-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation