Tidewater Physical Therapy, LLC

NPI #1093172181 in Virginia Beach, Virginia

Provider Information

NPI Number
1093172181
Entity Type
Organization
Organization Name
Tidewater Physical Therapy, LLC
Primary Specialty
Physical Therapist
Enumeration Date
Jan 21, 2016
Last Updated
Nov 25, 2024

Practice Location

Address
1745 CAMELOT DR
Address 2
SUITE 100
ZIP Code
23454-2435
Phone
(757) 961-4800

Authorized Official

Name
TASHEDA BROUGHTON, PESC
Title
MANGER, CREDENTIALING
Phone
(252) 248-3313

Specialties & Taxonomy Codes

Specialty
Occupational Therapist
Physical Therapist

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