Tidewater Physical Therapy LLC
NPI #1497244800 in Fredericksburg, Virginia
Provider Information
- NPI Number
- 1497244800
- Entity Type
- Organization
- Organization Name
- Tidewater Physical Therapy LLC
- Primary Specialty
- Physical Therapist
- Enumeration Date
- May 2, 2018
- Last Updated
- Nov 25, 2024
Practice Location
- Address
- 5629 PLANK RD STE 107
- City
- Fredericksburg
- State
- Virginia
- ZIP Code
- 22407-7216
- Phone
- (540) 445-0206
Authorized Official
- Name
- TASHEDA BROUGHTON, PESC
- Title
- MANAGER, CREDENTIALING
- Phone
- (252) 248-3313
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physical Therapist |
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