# MINDFUL PERFORMANCE CENTER LIMITED LIABILITY COMPANY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1972074839
- **Authorized official:** JIMMY WARREN VIOLAND PTA (OWNER)
- **Authorized official phone:** (443) 538-5758

## Contact information

- **Practice address:** 6570 DOBBIN RD, COLUMBIA, MD 21045-5855
- **Practice address phone:** (443) 538-5758
- **Mailing address:** 13380 CLARKSVILLE PIKE STE I, HIGHLAND, MD 20777-9725
- **Mailing address phone:** (443) 538-5758

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2083S0010X | Sports Medicine (Preventive Medicine) Physician | — | NULL | — |
| 2083S0010X | Sports Medicine (Preventive Medicine) Physician | — | — | — |
| 261QP2000X | Physical Therapy Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 12/17/2018
- **Last updated:** 05/12/2020