Provider Demographics
NPI:1801061346
Name:VIRGIL BIOSYMMETRY PHYSICAL THERAPY,INC
Entity type:Organization
Organization Name:VIRGIL BIOSYMMETRY PHYSICAL THERAPY,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BEATRICE
Authorized Official - Middle Name:ARCILLA
Authorized Official - Last Name:MERZA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:213-382-5566
Mailing Address - Street 1:621 S VIRGIL AVE STE 310
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90005-4047
Mailing Address - Country:US
Mailing Address - Phone:213-382-5566
Mailing Address - Fax:213-382-5575
Practice Address - Street 1:621 S VIRGIL AVE STE 310
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90005-4047
Practice Address - Country:US
Practice Address - Phone:213-382-5566
Practice Address - Fax:213-382-5575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-25
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT26836225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty