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General NPI Number Information
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NPI Number | 1902131725
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Entity Type | Organization
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Legal Business Name | DOMINION PHYSICAL THERAPY AND ASSOCIATES INCORPORATED
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Dates
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Enumeration Date | 10/13/2009
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Last Update Date | 07/24/2025
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Provider Practice Location Address
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Address Line | 304 MARCELLA RD SUITE E
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City | HAMPTON
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State | VA
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Zip | 23666-2578
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Country | US
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Telephone | 757-597-9510
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Fax |
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Provider Business Mailing Address
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Address Line | 729 THIMBLE SHOALS BLVD SUITE 4A
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City | NEWPORT NEWS
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State | VA
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Zip | 23606-4217
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Country | US
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Telephone | 757-597-9510
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ALLEN JONES
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Credential |
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Telephone | 757-597-9510
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 2305206151
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License Number State | VA
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