Provider Demographics
NPI:1508249632
Name:SPOT ON THERAPY GROUP LLC
Entity Type:Organization
Organization Name:SPOT ON THERAPY GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:S
Authorized Official - Last Name:RILEY
Authorized Official - Suffix:
Authorized Official - Credentials:MEDCCC/SLP
Authorized Official - Phone:804-525-0022
Mailing Address - Street 1:1627 INDIAN PIPE CT
Mailing Address - Street 2:
Mailing Address - City:POWHATAN
Mailing Address - State:VA
Mailing Address - Zip Code:23139-7044
Mailing Address - Country:US
Mailing Address - Phone:804-525-0022
Mailing Address - Fax:807-598-2492
Practice Address - Street 1:1627 INDIAN PIPE CT
Practice Address - Street 2:
Practice Address - City:POWHATAN
Practice Address - State:VA
Practice Address - Zip Code:23139-7044
Practice Address - Country:US
Practice Address - Phone:804-525-0022
Practice Address - Fax:807-598-2492
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-07
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202001786235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty