Organization
ATLANTIC SPORTS & REHABILITATION SERVICES, INC
Active
Other names
Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MARK W TULENKO MPT OCS (DIRECTOR)
(434) 978-4915
Entity
Organization
Contact information
Practice address
1410 INCARNATION DR, SUITE 101, CHARLOTTESVILLE, VA 22901-5708
(434) 978-4915
(434) 978-7194
Mailing address
1410 INCARNATION DR, SUITE 101, CHARLOTTESVILLE, VA 22901-5708
(434) 978-4915
(434) 978-7194
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2315014631
VA
261QR0400X
Rehabilitation Clinic/Center
2305004631
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004980328
—
VA
Enumeration date
04/05/2006
Last updated
07/03/2012
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