Tidewater Physical Therapy, LLC
NPI #1669493474 in Newport News, Virginia
Provider Information
- NPI Number
- 1669493474
- Entity Type
- Organization
- Organization Name
- Tidewater Physical Therapy, LLC
- Primary Specialty
- Physical Therapist
- Enumeration Date
- Jul 21, 2006
- Last Updated
- Nov 19, 2024
Practice Location
- Address
- 751 J CLYDE MORRIS BLVD
- City
- Newport News
- State
- Virginia
- ZIP Code
- 23601-1538
- Phone
- (757) 873-2123
Authorized Official
- Name
- TASHEDA BROUGHTON
- Title
- CREDENTIALING MANAGER
- Phone
- (252) 248-3313
Specialties & Taxonomy Codes
| Specialty |
|---|
| Occupational Therapist |
| Clinic/Center |
| Physical Therapist |
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