Tidewater Physical Therapy LLC

NPI #1538680400 in Norfolk, Virginia

Provider Information

NPI Number: 1538680400
Entity Type: Organization
Organization Name: Tidewater Physical Therapy LLC
Primary Specialty: Physical Therapist
Enumeration Date: Jun 30, 2017
Last Updated: Nov 25, 2024

Practice Location

Address: 250 W BRAMBLETON AVE STE 100
City: Norfolk
State: Virginia
ZIP Code: 23510-1542
Phone: (757) 938-6608

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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