Tidewater Physical Therapy, LLC

NPI #1659887396 in Dumfries, Virginia

Provider Information

NPI Number
1659887396
Entity Type
Organization
Organization Name
Tidewater Physical Therapy, LLC
Primary Specialty
Physical Therapist
Enumeration Date
Dec 18, 2017
Last Updated
Nov 25, 2024

Practice Location

Address
4214 FORTUNA CENTER PLZ
ZIP Code
22025-1515
Phone
(571) 402-2028

Authorized Official

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

Specialties & Taxonomy Codes

Specialty
Physical Therapist

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