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Organization
THERAPY 360, LLC
Active
Organization
THERAPY 360, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GILES ALEXANDER JACKSON PH.D. (MANAGER)
(202) 257-4854
Entity
Organization
Contact information
Practice address
716 LEVY AVE, CHARLOTTESVILLE, VA 22902-5730
12022574854
(800) 923-4304
Mailing address
716 LEVY AVE, CHARLOTTESVILLE, VA 22902-5730
12022574854
(800) 923-4304
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305004961
VA
Other
Enumeration date
06/28/2017
Last updated
06/28/2017
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