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Organization
MINDFUL PERFORMANCE CENTER LIMITED LIABILITY COMPANY
Active
Organization
MINDFUL PERFORMANCE CENTER LIMITED LIABILITY COMPANY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JIMMY WARREN VIOLAND PTA (OWNER)
(443) 538-5758
Entity
Organization
Contact information
Practice address
6570 DOBBIN RD, COLUMBIA, MD 21045-5855
(443) 538-5758
Mailing address
13380 CLARKSVILLE PIKE STE I, HIGHLAND, MD 20777-9725
(443) 538-5758
Taxonomy
Speciality
Code
Description
License number
State
2083S0010X
Sports Medicine (Preventive Medicine) Physician
—
NULL
2083S0010X
Sports Medicine (Preventive Medicine) Physician
—
—
261QP2000X
Physical Therapy Clinic/Center
Primary
—
NULL
Other
Enumeration date
12/17/2018
Last updated
05/12/2020
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