Healthcare Provider Details

I. General information

NPI: 1508847591
Provider Name (Legal Business Name): DIANNE ELLEN EPPLEIN PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DIANNE ELLEN DAVIDSON PT

II. Dates (important events)

Enumeration Date: 11/08/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

818 NEWTOWN RD
VIRGINIA BEACH VA
23462-1116
US

IV. Provider business mailing address

818 NEWTOWN RD
VIRGINIA BEACH VA
23462-1116
US

V. Phone/Fax

Practice location:
  • Phone: 757-473-8016
  • Fax: 757-473-3580
Mailing address:
  • Phone: 757-473-8016
  • Fax: 757-473-3580

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305 000587
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code225000000X
TaxonomyOrthotic Fitter
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: