MEDICARE: PHYSICAL THERAPY WORKS, INC.

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	261QP2000X	Physical Therapy Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366433112
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHYSICAL THERAPY WORKS, INC.

Provider Business Mailing Address
First Line	:	2007 MEADE PKWY
Second Line	:
City	:	SUFFOLK
State	:	VA
Zip	:	23434-4259
Country	:	US
Telephone Number	:	757-539-6300
Fax Number	:	757-539-0704

Provider Business Practice Location Address
First Line	:	2007 MEADE PKWY
Second Line	:
City	:	SUFFOLK
State	:	VA
Zip	:	23434-4259
Country	:	US
Telephone Number	:	757-539-6300
Fax Number	:	757-539-0704

Authorized Official
Title or Position	:	PRACTICE ADMINISTRATOR
Name	:	MR. JOHN TRENTON BISHOP
Credential	:
Telephone Number	:	757-539-6300

Provider Enumeration Date	:	11/01/2005
Last Update Date	:	07/16/2012

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