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Tidewater Medspa Pllc
Health Service Clinic/Center in Portsmouth, Virginia
NPI 1356099113

Tidewater Medspa Pllc is a Health Service Clinic/Center based in Portsmouth, VA and is specialized in Health Service. Tidewater Medspa Pllc practices in Portsmouth, VA. The NPI Number for Tidewater Medspa Pllc is 1356099113 and holds a License No. (Virginia).

The current practice location address for Tidewater Medspa Pllc is 3400 Airline Blvd, Portsmouth, VA and can be reached out via phone at 757-470-9454.

Location: 3400 Airline Blvd, Portsmouth, VA, 23701-2623
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1356099113
Provider Name
Tidewater Medspa Pllc
Credential
Provider Entity Type
Organization
Address
3400 Airline Blvd, Portsmouth, VA, 23701-2623
Phone Number
757-470-9454
Fax Number
Provider Enumeration Date
03/11/2022
Last Update Date
03/13/2024
institution
Provider Business Practice Location Address Details
Address
3400 Airline Blvd
City
Portsmouth
State
Virginia
Zip
23701-2623
Phone Number
757-470-9454
Fax Number
person
Provider Business Mailing Address Details
Address
3400 Airline Blvd
City
Portsmouth
State
Virginia
Zip
23701-2623
Phone Number
757-470-9454
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Health Service
Taxonomy
261QH0100X
License No.
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Definition
Definition to come...
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