NPI 1003114083

Tidewater Physical Therapy, LLC

Organisation Physical Therapist Richmond, VA

Practice location

Address: 4831 S Laburnum Ave, Richmond, VA 23231-2713
Phone: (804) 222-0746
Fax: (804) 222-0728
Mailing address: 2122 York Rd STE 300, Oak Brook, IL 60523-1925

Authorised official

Name: Tasheda Broughton
Title: Manger, Credentialing
Phone: (252) 248-3313

Registered specialties (2)

Physical Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225100000X

Other Physical Therapist providers in Virginia →

Occupational Therapist

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225X00000X

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Registry record

NPI: 1003114083
Entity type: Organization
NPI issued: 1 Mar 2011
Record last updated: 25 Nov 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.