Healthcare Provider Details
I. General information
NPI: 1477258390
Provider Name (Legal Business Name): SENTARA THERAPY SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/31/2023
Last Update Date: 03/31/2023
Certification Date: 03/29/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3509 VIRGINIA BEACH BLVD
VIRGINIA BEACH VA
23452-4421
US
IV. Provider business mailing address
3509 VIRGINIA BEACH BLVD
VIRGINIA BEACH VA
23452-4421
US
V. Phone/Fax
- Phone: 757-261-4475
- Fax: 757-222-3156
- Phone: 757-261-4475
- Fax: 757-222-3156
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225700000X |
| Taxonomy | Massage Therapist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DORIS
PRINCE
Title or Position: DIRECTOR
Credential:
Phone: 757-983-5475