Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Tidewater Physical Therapy LLC

Organization Physical Therapist · NPI 1144972159

Tidewater Physical Therapy LLC is a Physical Therapist in Suffolk, Virginia. Registered with an NPI since 2022.

In the registry since
2022
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1033 Champions Way Ste 500
Suffolk, VA 23435-3775
Phone: (757) 372-9953
Fax: (757) 372-9954
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X

Record details

NPI number1144972159
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Tasheda Broughton — Manager, Credentialing · (252) 248-3313
NPI enumeratedJanuary 20, 2022
Last updated in NPPESNovember 25, 2024
Certification dateNovember 25, 2024
Mailing address350 New Fidelity Ct, Garner, NC 27529-2665

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