Healthcare Provider Details

I. General information

NPI: 1174401798
Provider Name (Legal Business Name): SANDRA TIBBS PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2025
Last Update Date: 09/18/2025
Certification Date: 09/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1481 SENSENY RD
WINCHESTER VA
22602-6421
US

IV. Provider business mailing address

101 WHISTLER CT
WINCHESTER VA
22602-2380
US

V. Phone/Fax

Practice location:
  • Phone: 540-665-0103
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305202060
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: