Provider Demographics
NPI:1467510347
Name:FUNCTIONAL HUMAN PERFORMANCE, P.C.
Entity Type:Organization
Organization Name:FUNCTIONAL HUMAN PERFORMANCE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:HUTCHINSON
Authorized Official - Last Name:CALL
Authorized Official - Suffix:
Authorized Official - Credentials:MSATC,CSCS
Authorized Official - Phone:757-418-3487
Mailing Address - Street 1:1126 MAGNOLIA AVE
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23508
Mailing Address - Country:US
Mailing Address - Phone:757-418-3487
Mailing Address - Fax:757-489-1350
Practice Address - Street 1:1126 MAGNOLIA AVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23508-1413
Practice Address - Country:US
Practice Address - Phone:757-418-3487
Practice Address - Fax:757-489-1350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
VA01260007022255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Not Answered2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic TrainerGroup - Multi-Specialty