Tidewater Physical Therapy, Llc
LBN: Tidewater Physical Therapy, Llc
Tidewater Physical Therapy, Llc is an health care organization with primary practice located at 1745 Camelot Dr Suite 100, Virginia Beach VA 23454-2435. The organization recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist is the primary health care specialty.
Tidewater Physical Therapy, Llc can be contacted via phone (757) 961-4800, or through Broughton, Tasheda via phone (252) 248-3313.
Contact Information
Primary practice address
1745 Camelot Dr Suite 100
Virginia Beach VA 23454-2435
Phone: (757) 961-4800
Fax: (757) 961-0233
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | ||
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist | 225X00000X |
Profile Details
| NPI number | 1093172181 |
|---|---|
| LBN Legal business name | Tidewater Physical Therapy, Llc |
| DBA Doing business as | |
| Authorized official | Broughton, Tasheda PESC |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jan 21st, 2016 |
| Last updated | Nov 25th, 2024 - about 2 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1093172181 | NPPES |
| Virginia | Other | C05954 | MEDICARE GROUP PTAN |
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