Healthcare Provider Details

I. General information

NPI: 1851770598
Provider Name (Legal Business Name): JP THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2015
Last Update Date: 05/29/2024
Certification Date: 05/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5604 VIRGINIA BEACH BLVD STE 101
VIRGINIA BEACH VA
23462-5631
US

IV. Provider business mailing address

5604 VIRGINIA BEACH BLVD STE 101
VIRGINIA BEACH VA
23462-5631
US

V. Phone/Fax

Practice location:
  • Phone: 757-455-5000
  • Fax: 757-319-4142
Mailing address:
  • Phone: 757-455-5000
  • Fax: 757-319-4142

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number0119003742
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. JOSHUA MATTHEW ADLER
Title or Position: OWNER/DIRECTOR
Credential: OTR/L
Phone: 757-472-2513