Tidewater Physical Therapy, LLC

NPI #1982889408 in Mechanicsville, Virginia

Provider Information

NPI Number: 1982889408
Entity Type: Organization
Organization Name: Tidewater Physical Therapy, LLC
Primary Specialty: Physical Therapist
Enumeration Date: Jan 3, 2008
Last Updated: Dec 6, 2024

Practice Location

Address: 7493 RIGHT FLANK RD
Address 2: SUITE 410
City: Mechanicsville
State: Virginia
ZIP Code: 23116-3846
Phone: (804) 569-7091

Authorized Official

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

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapist	225X00000X
Physical Therapist	225100000X	Primary

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