Tidewater Physical Therapy, LLC

NPI #1609004571 in Powhatan, Virginia

Provider Information

NPI Number
1609004571
Entity Type
Organization
Organization Name
Tidewater Physical Therapy, LLC
Primary Specialty
Physical Therapist
Enumeration Date
Jun 30, 2009
Last Updated
Nov 25, 2024

Practice Location

Address
3510 ANDERSON HWY
Address 2
SUITE 2
ZIP Code
23139
Phone
(804) 598-2100

Authorized Official

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

Specialties & Taxonomy Codes

Specialty
Occupational Therapist
Physical Therapist

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