Healthcare Provider Details

I. General information

NPI: 1386675965
Provider Name (Legal Business Name): HANDS ON PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 08/28/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1940 SANDY HOOK RD SUITE F
GOOCHLAND VA
23063-3107
US

IV. Provider business mailing address

PO BOX 57
GOOCHLAND VA
23063-0057
US

V. Phone/Fax

Practice location:
  • Phone: 804-556-7181
  • Fax: 804-556-7182
Mailing address:
  • Phone: 804-556-7181
  • Fax: 804-556-7182

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305004559
License Number StateVA

VIII. Authorized Official

Name: MR. DAVID MATTHEW CARTER
Title or Position: OWNER
Credential: MSPT
Phone: 804-556-7181