Healthcare Provider Details

I. General information

NPI: 1073573242
Provider Name (Legal Business Name): DOMINION PHYSICAL THERAPY & ASSOCIATES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2006
Last Update Date: 06/04/2025
Certification Date: 06/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 MARCELLA ROAD SUITE E
HAMPTON VA
23666
US

IV. Provider business mailing address

729 THIMBLE SHOALS BLVD SUITE 4C
NEWPORT NEWS VA
23606-4217
US

V. Phone/Fax

Practice location:
  • Phone: 757-825-9446
  • Fax: 757-825-9476
Mailing address:
  • Phone: 757-873-2932
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. ALLEN R JONES JR.
Title or Position: CEO
Credential:
Phone: 757-873-2932