Organization
REBOOT FUNCTIONAL HEALTH CARE CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LAURIE DIERSTEIN (OWNER/AUTHORIZED OFFICIAL)
(757) 301-6985
Entity
Organization
Contact information
Practice address
2528 LAS BRISAS DR, VIRGINIA BEACH, VA 23456-4264
(757) 301-6985
Mailing address
2528 LAS BRISAS DR, VIRGINIA BEACH, VA 23456-4264
(757) 301-6985
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
01/11/2022
Last updated
01/11/2022
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