Healthcare Provider Details

I. General information

NPI: 1033326491
Provider Name (Legal Business Name): PHYSICAL THERAPY WORKS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2007
Last Update Date: 06/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2007 MEADE PKWY
SUFFOLK VA
23434-4259
US

IV. Provider business mailing address

2007 MEADE PKWY
SUFFOLK VA
23434-4259
US

V. Phone/Fax

Practice location:
  • Phone: 757-539-6300
  • Fax: 757-539-0704
Mailing address:
  • Phone: 757-539-6300
  • Fax: 757-539-0704

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: JOHN TRENTON BISHOP
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 757-539-6300