Tidewater Physical Therapy LLC

NPI #1205345444 in Norfolk, Virginia

Provider Information

NPI Number: 1205345444
Entity Type: Organization
Organization Name: Tidewater Physical Therapy LLC
Primary Specialty: Physical Therapist
Enumeration Date: Sep 20, 2017
Last Updated: Nov 25, 2024

Practice Location

Address: 154 E LITTLE CREEK RD
City: Norfolk
State: Virginia
ZIP Code: 23505-2503
Phone: (757) 797-0210

Authorized Official

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

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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