MEDICARE: PERSONAL TOUCH THERAPY

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	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1427516988
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PERSONAL TOUCH THERAPY

Provider Business Mailing Address
First Line	:	1304 DOMINION LAKES BLVD
Second Line	:
City	:	CHESAPEAKE
State	:	VA
Zip	:	23320-6451
Country	:	US
Telephone Number	:	757-576-7274
Fax Number	:

Provider Business Practice Location Address
First Line	:	1304 DOMINION LAKES BLVD
Second Line	:
City	:	CHESAPEAKE
State	:	VA
Zip	:	23320-6451
Country	:	US
Telephone Number	:	757-576-7274
Fax Number	:

Authorized Official
Title or Position	:	PHYSICAL THERAPY OWNER
Name	:	MRS. JEVIE LEE O'NEILL
Credential	:	DPT
Telephone Number	:	757-576-7274

Provider Enumeration Date	:	03/04/2019
Last Update Date	:	03/04/2019

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Directions to “PERSONAL TOUCH THERAPY ” Practice Location

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