| Tidewater Physical Therapy, Llc | |
|
4125 Ironbound Rd, Ste 100, Williamsburg, VA 23188-2666 | |
| (757) 220-8383 | |
| (757) 253-7833 |
| Full Name | Tidewater Physical Therapy, Llc |
|---|---|
| Type | Facility |
| Speciality | Physical Therapist |
| Location | 4125 Ironbound Rd, Williamsburg, Virginia |
| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033138094 | NPI | - | NPPES |
| 192935 | Other | VA | BCBS (PT) |
| 192937 | Other | VA | BCBS (OT) |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | (* (Not Available)) | Primary |
| 225X00000X | Occupational Therapist | (* (Not Available)) | Secondary |
| Mailing Address | Practice Location Address |
|---|---|
| Tidewater Physical Therapy, Llc 2122 York Rd Ste 300, Oak Brook, IL 60523-1925 Ph: (252) 248-3133 | Tidewater Physical Therapy, Llc 4125 Ironbound Rd, Ste 100, Williamsburg, VA 23188-2666 Ph: (757) 220-8383 |
Tara Lee Perkins, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 111 Bulifants Blvd Ste A, Williamsburg, VA 23188 Phone: 757-564-7381 Fax: 757-564-7391 | |
Ann Degruy Scanlon, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 5700 Warhill Trl, Williamsburg, VA 23188 Phone: 757-912-2726 | |
Joshua James Simons, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 201 Bulifants Blvd Ste B, Williamsburg, VA 23188 Phone: 757-229-9740 Fax: 757-229-9741 | |
D Russell Mosher, PT Physical Therapist Medicare: Medicare Enrolled Practice Location: 109 Bulifants Blvd, Suite B, Williamsburg, VA 23188 Phone: 757-229-9740 Fax: 757-345-6953 | |
Karen Mcpadden, MPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 5388 Discovery Park Blvd Ste 100, Williamsburg, VA 23188 Phone: 757-903-4230 Fax: 757-903-4231 | |