1457389595 TIDEWATER PHYSICAL THERAPY, LLC

Physical Therapist

Active

Basic Information

Organization Name
TIDEWATER PHYSICAL THERAPY, LLC
Enumeration Date
June 29, 2006
Last Update
November 19, 2024
Authorized Official
TASHEDA BROUGHTON PESC
MANAGER, CREDENTIALING
Phone: (252) 248-3313

Practice Location

Address
10128 W BROAD ST BLDG III
GLEN ALLEN, VA 230606761
Phone
(804) 217-9210
Fax
(804) 217-9213

Mailing Address

Address
2122 YORK RD STE 300
OAK BROOK, IL 605231925
Phone
(252) 248-3313
Fax
(410) 648-4878

Specialties & Taxonomies

Specialty Code Classification License State Primary
Occupational Therapist
 225X00000X Occupational Therapist N/A N/A No
Speech-Language Pathologist
 235Z00000X Speech-Language Pathologist N/A N/A No
Clinic/Center
 261Q00000X Clinic/Center N/A N/A No
Physical Therapist
 225100000X Physical Therapist N/A N/A Primary

Other Identifiers

Identifier Type State Issuer
C12068 01 VA MEDICARE RAILROAD

Frequently Asked Questions

What is TIDEWATER PHYSICAL THERAPY, LLC's NPI number?
TIDEWATER PHYSICAL THERAPY, LLC's NPI number is 1457389595.
Which doctor has NPI number 1457389595?
The doctor with NPI number 1457389595 is TIDEWATER PHYSICAL THERAPY, LLC.
What is TIDEWATER PHYSICAL THERAPY, LLC's practice address?
TIDEWATER PHYSICAL THERAPY, LLC's practice address is 10128 W BROAD ST BLDG III, GLEN ALLEN, VA, 230606761.
Which doctor practices at 10128 W BROAD ST BLDG III, GLEN ALLEN, VA, 230606761?
TIDEWATER PHYSICAL THERAPY, LLC practices at 10128 W BROAD ST BLDG III, GLEN ALLEN, VA, 230606761.
What is TIDEWATER PHYSICAL THERAPY, LLC's mailing address?
TIDEWATER PHYSICAL THERAPY, LLC's mailing address is 2122 YORK RD STE 300, OAK BROOK, IL, 605231925.
What is TIDEWATER PHYSICAL THERAPY, LLC's phone number?
TIDEWATER PHYSICAL THERAPY, LLC's phone number is (804) 217-9210.
Who is (804) 217-9210?
(804) 217-9210 is the phone number for TIDEWATER PHYSICAL THERAPY, LLC.
What is TIDEWATER PHYSICAL THERAPY, LLC's specialty?
TIDEWATER PHYSICAL THERAPY, LLC's specialty is Physical Therapist.
What type of doctor is TIDEWATER PHYSICAL THERAPY, LLC?
TIDEWATER PHYSICAL THERAPY, LLC is a Physical Therapist.
Is TIDEWATER PHYSICAL THERAPY, LLC a Physical Therapist?
Yes, TIDEWATER PHYSICAL THERAPY, LLC is a Physical Therapist.
Is TIDEWATER PHYSICAL THERAPY, LLC still practicing?
Yes, TIDEWATER PHYSICAL THERAPY, LLC is currently practicing.
Is TIDEWATER PHYSICAL THERAPY, LLC accepting new patients?
TIDEWATER PHYSICAL THERAPY, LLC may be accepting new patients. Please call their office at (804) 217-9210 to inquire about availability.
Is NPI 1457389595 still active?
Yes, NPI 1457389595 is currently active.
Where does TIDEWATER PHYSICAL THERAPY, LLC practice?
TIDEWATER PHYSICAL THERAPY, LLC practices in GLEN ALLEN, VA.