Provider Demographics
NPI:1225230709
Name:DULA, VIRGINIA F (PT)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:F
Last Name:DULA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 BRIGHTLEAF DR
Mailing Address - Street 2:
Mailing Address - City:WHISPERING PINES
Mailing Address - State:NC
Mailing Address - Zip Code:28327-0105
Mailing Address - Country:US
Mailing Address - Phone:404-520-0508
Mailing Address - Fax:
Practice Address - Street 1:212 BRIGHTLEAF DR
Practice Address - Street 2:
Practice Address - City:WHISPERING PINES
Practice Address - State:NC
Practice Address - Zip Code:28327
Practice Address - Country:US
Practice Address - Phone:404-520-0508
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2018-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC96932251X0800X
VA2305205281174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty
No174400000XOther Service ProvidersSpecialistGroup - Single Specialty