Ryan P Eastridge, PT, DPT | |
4214 Fortuna Center Plz, Dumfries, VA 22025-1515 | |
(571) 402-2098 | |
(571) 888-8048 |
Full Name | Ryan P Eastridge |
---|---|
Gender | Male |
Speciality | Physical Therapy |
Experience | 10 Years |
Location | 4214 Fortuna Center Plz, Dumfries, Virginia |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1710395934 | NPI | - | NPPES |
C05954 | Other | VA | GROUP MEDICARE PTAN |
1710395934 | Other | VA | MEDICAID QMB |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 2305208868 (Virginia) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Tidewater Physical Therapy Llc | 6406759281 | 188 |
Provider Name | Tidewater Physical Therapy Llc |
---|---|
Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Provider Identifiers | NPI Number: 1457389595 PECOS PAC ID: 6406759281 Enrollment ID: O20041019001029 |
Mailing Address | Practice Location Address |
---|---|
Ryan P Eastridge, PT, DPT Po Box 69030, Baltimore, MD 21264-9030 Ph: (757) 873-2302 | Ryan P Eastridge, PT, DPT 4214 Fortuna Center Plz, Dumfries, VA 22025-1515 Ph: (571) 402-2098 |
Punith Kumar Shivapura Nanjundaiah, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 3600 Pointe Center Ct Ste 110, Dumfries, VA 22026 Phone: 757-523-1790 | |
Robert W Lyman, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 4214 Fortuna Center Plz, Dumfries, VA 22025 Phone: 571-402-2098 Fax: 434-951-2194 | |
Teonette O Velasco, M.P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 17453 Jefferson Davis Hwy, Dumfries, VA 22026 Phone: 703-221-3913 Fax: 703-221-3203 | |
Amanda G Hopkins, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 3700 Fettler Park Dr, Dumfries, VA 22025 Phone: 703-441-7658 | |
Professional Physical Therapy Llc Physical Therapist Medicare: Medicare Enrolled Practice Location: 3767 Fettler Park Dr, Dumfries, VA 22025 Phone: 703-730-6400 | |
Dr. William Glynn Kotulan, PHYSICAL THERAPIST Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 3700 Fettler Park Dr, Dumfries, VA 22025 Phone: 703-441-7500 | |
Mrs. Kathleen Ann Newmeyer, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 700 Fettler Park, Dumfries Health Center, Dumfries, VA 22025 Phone: 703-441-7500 |