Tidewater Physical Therapy LLC
NPI #1588172993 in Charlottesville, Virginia
Provider Information
- NPI Number
- 1588172993
- Entity Type
- Organization
- Organization Name
- Tidewater Physical Therapy LLC
- Primary Specialty
- Physical Therapist
- Enumeration Date
- Jan 19, 2018
- Last Updated
- Nov 25, 2024
Practice Location
- Address
- 229 CONNOR DR
- City
- Charlottesville
- State
- Virginia
- ZIP Code
- 22911-5604
- Phone
- (434) 218-1021
Authorized Official
- Name
- TASHEDA BROUGHTON, PESC
- Title
- MANAGER, CREDENTIALING
- Phone
- (252) 248-3313
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physical Therapist |
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