MEDICARE: JOHN COLT STILES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225200000X	Physical Therapy Assistant

General Provider Information

NPI Number	:	1366301459
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN COLT STILES

Provider Business Mailing Address
First Line	:	2076 S INDEPENDENCE BLVD STE 1B
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23453-4773
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2076 S INDEPENDENCE BLVD STE 1B
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23453-4773
Country	:	US
Telephone Number	:	757-622-7272
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/15/2026
Last Update Date	:	01/15/2026

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