| Altitude Iop, Llc | |
|
708 S Main St Blacksburg VA 24060-5210 | |
| (540) 953-5090 | |
| (540) 953-5095 |
| Full Name | Altitude Iop, Llc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 708 S Main St, Blacksburg, Virginia |
| Authorized Official Name and Position | Karla Soukup (PROGRAM THERAPIST) |
| Authorized Official Contact | 5409535090 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Altitude Iop, Llc 708 S Main St Blacksburg VA 24060-5210 Ph: (540) 953-5090 | Altitude Iop, Llc 708 S Main St Blacksburg VA 24060-5210 Ph: (540) 953-5090 |
| NPI Number | 1033598982 |
|---|---|
| Provider Enumeration Date | 05/26/2015 |
| Last Update Date | 05/26/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033598982 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | 0717001173 (Virginia) | Primary |
| 133V00000X | Dietitian, Registered | 953736 (Virginia) | Secondary |
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