Healthcare Provider Details

I. General information

NPI: 1124600226
Provider Name (Legal Business Name): TIFFANY HOWLETT PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2021
Last Update Date: 05/05/2021
Certification Date: 05/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

154 E LITTLE CREEK RD
NORFOLK VA
23505-2503
US

IV. Provider business mailing address

350 NEW FIDELITY CT
GARNER NC
27529-2665
US

V. Phone/Fax

Practice location:
  • Phone: 757-797-0210
  • Fax:
Mailing address:
  • Phone: 919-258-2714
  • Fax: 410-648-4878

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305213961
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: