Tidewater Physical Therapy, LLC
NPI #1942703491 in Blacksburg, Virginia
Provider Information
- NPI Number
- 1942703491
- Entity Type
- Organization
- Organization Name
- Tidewater Physical Therapy, LLC
- Primary Specialty
- Physical Therapist
- Enumeration Date
- Mar 12, 2018
- Last Updated
- Dec 6, 2024
Practice Location
- Address
- 872 PRICES FORK RD
- City
- Blacksburg
- State
- Virginia
- ZIP Code
- 24060-3229
- Phone
- (540) 739-2161
Authorized Official
- Name
- TASHEDA BROUGHTON, PESC
- Title
- MANAGER, CREDENTIALING
- Phone
- (252) 248-3313
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physical Therapist |
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