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 1497244800

Tidewater Physical Therapy LLC is a Physical Therapist in Fredericksburg, Virginia. Licensed in Virginia. Registered with an NPI since 2018.

Licensed in
VA
In the registry since
2018
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

5629 Plank Rd Ste 107
Fredericksburg, VA 22407-7216
Phone: (540) 445-0206
Fax: (540) 739-7473
Show map & directions

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

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X (VA)

Record details

NPI number1497244800
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Tasheda Broughton — Manager, Credentialing · (252) 248-3313
Other names Pivot Physical Therapy Of Virginia
NPI enumeratedMay 2, 2018
Last updated in NPPESNovember 25, 2024
Certification dateNovember 25, 2024
Mailing address2122 York Rd Ste 300, Oak Brook, IL 60523-1925

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