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 1659887396

Tidewater Physical Therapy, LLC is a Physical Therapist in Dumfries, Virginia. Licensed in Virginia. Registered with an NPI since 2017.

Licensed in
VA
In the registry since
2017
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

4214 Fortuna Center Plz
Dumfries, VA 22025-1515
Phone: (571) 402-2028
Fax: (571) 888-8048
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 number1659887396
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Tasheda Broughton — Manager, Credentialing · (252) 248-3313
Other names Pivot Physical Therapy
NPI enumeratedDecember 18, 2017
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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