Tidewater Medspa Pllc
NPI #1356099113 in Portsmouth, Virginia
Provider Information
- NPI Number
- 1356099113
- Entity Type
- Organization
- Organization Name
- Tidewater Medspa Pllc
- Primary Specialty
- Clinic/Center - Health Service
- Enumeration Date
- Mar 11, 2022
- Last Updated
- Mar 11, 2022
Practice Location
- Address
- 3400 AIRLINE BLVD
- City
- Portsmouth
- State
- Virginia
- ZIP Code
- 23701-2623
- Phone
- (757) 470-9454
Authorized Official
- Name
- MARGOT WILSON, FNP
- Title
- OWNER
- Phone
- (757) 470-9454
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Health Service — Health Service |
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