Provider Demographics
NPI:1255486189
Name:ENCORE PILATES AND PHYSICAL THERAPY
Entity Type:Organization
Organization Name:ENCORE PILATES AND PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PHYSICAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:757-408-4068
Mailing Address - Street 1:337 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SMITHFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23430-1346
Mailing Address - Country:US
Mailing Address - Phone:757-408-4068
Mailing Address - Fax:757-357-2018
Practice Address - Street 1:337 MAIN ST
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:VA
Practice Address - Zip Code:23430-1346
Practice Address - Country:US
Practice Address - Phone:757-408-4068
Practice Address - Fax:757-357-2018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305005851225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1366477523OtherPERSONAL NPI #