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General NPI Number Information
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NPI Number | 1013869775
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Entity Type | Individual
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Provider Name | TY JAMES BENNETT PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 02/13/2026
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Last Update Date | 02/13/2026
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Provider Practice Location Address
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Address Line | 1117 BERRYVILLE AVE
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City | WINCHESTER
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State | VA
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Zip | 22601-5919
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Country | US
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Telephone | 833-493-4325
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Fax | 833-918-2233
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Provider Business Mailing Address
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Address Line | 172 LINDEN DR STE 100
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City | WINCHESTER
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State | VA
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Zip | 22601-2892
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Country | US
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Telephone | 540-722-8172
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Fax | 540-723-8772
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2305217601
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License Number State | VA
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