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General NPI Number Information
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NPI Number | 1356311880
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Entity Type | Organization
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Legal Business Name | PENINSULA PHYSICAL THERAPY & ASSOCIATES, INC
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Dates
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Enumeration Date | 01/26/2006
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Last Update Date | 09/06/2016
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Provider Practice Location Address
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Address Line | 1618 HARDY CASH DR
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City | HAMPTON
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State | VA
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Zip | 23666-2400
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Country | US
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Telephone | 757-838-7453
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Fax | 757-838-2314
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Provider Business Mailing Address
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Address Line | 1618 HARDY CASH DR
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City | HAMPTON
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State | VA
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Zip | 23666-2400
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Country | US
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Telephone | 757-838-7453
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Fax | 757-838-2314
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Authorized Official
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Title or Position | PRESIDENT / CEO
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Name | MR. ANGELO L SUGGS
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Credential | PT
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Telephone | 757-838-7453
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 2305001701
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License Number State | VA
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