Healthcare Provider Details

I. General information

NPI: 1295697779
Provider Name (Legal Business Name): STEVEN B PHILLIPS DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2025
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4554 VIRGINIA BEACH BLVD STE 970
VIRGINIA BEACH VA
23462-3047
US

IV. Provider business mailing address

2645 BERNADOTTE ST
VIRGINIA BEACH VA
23456-6509
US

V. Phone/Fax

Practice location:
  • Phone: 757-742-3778
  • Fax: 757-585-3787
Mailing address:
  • Phone: 757-742-3778
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305217525
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: