Provider Demographics
NPI:1316645963
Name:FUSION THERAPISTS
Entity type:Organization
Organization Name:FUSION THERAPISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:ENFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-906-0449
Mailing Address - Street 1:699 BERKMAR CT
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22901-1406
Mailing Address - Country:US
Mailing Address - Phone:434-214-0504
Mailing Address - Fax:
Practice Address - Street 1:699 BERKMAR CT
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901-1406
Practice Address - Country:US
Practice Address - Phone:434-214-0504
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-22
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty