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General NPI Number Information
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NPI Number | 1174544431
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Entity Type | Organization
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Legal Business Name | TUCKAHOE PHYSICAL THERAPY CORP
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Dates
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Enumeration Date | 07/22/2006
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Last Update Date | 07/23/2007
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Provider Practice Location Address
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Address Line | 32 BROAD STREET RD
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City | MANAKIN SABOT
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State | VA
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Zip | 23103-2213
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Country | US
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Telephone | 804-784-7090
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Fax | 804-784-7092
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Provider Business Mailing Address
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Address Line | 32 BROAD STREET RD
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City | MANAKIN SABOT
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State | VA
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Zip | 23103-2213
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Country | US
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Telephone | 804-784-7090
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Fax | 804-784-7092
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOSEPH S SUTTER
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Credential | MSPT
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Telephone | 804-784-7090
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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 |
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License Number State |
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