MEDICARE: CASEY POWLES DPT

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	2305209444	VA
2	225100000X	Physical Therapist	CP053881T	NC

General Provider Information

NPI Number	:	1871972034
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CASEY POWLES DPT

Provider Business Mailing Address
First Line	:	1016 FIRST COLONIAL RD
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23454-3073
Country	:	US
Telephone Number	:	757-481-4066
Fax Number	:	757-481-3779

Provider Business Practice Location Address
First Line	:	101 MEDICAL DR
Second Line	:
City	:	ELIZABETH CITY
State	:	NC
Zip	:	27909-3361
Country	:	US
Telephone Number	:	252-338-2114
Fax Number	:

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

Provider Enumeration Date	:	05/21/2015
Last Update Date	:	03/10/2026

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Directions to “ CASEY POWLES DPT” Practice Location

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