Provider Demographics
NPI:1457068595
Name:DEVINE PHYSICAL THERAPY AND WELLNESS
Entity Type:Organization
Organization Name:DEVINE PHYSICAL THERAPY AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:EILEEN
Authorized Official - Middle Name:DEVINE
Authorized Official - Last Name:SALVI
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:301-980-4301
Mailing Address - Street 1:220 GEESE LNDG
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23060-5875
Mailing Address - Country:US
Mailing Address - Phone:301-980-4301
Mailing Address - Fax:
Practice Address - Street 1:220 GEESE LNDG
Practice Address - Street 2:
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23060-5875
Practice Address - Country:US
Practice Address - Phone:301-980-4301
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-28
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty