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

Tidewater Physical Therapy, LLC

Organization Physical Therapist · NPI 1790270973

Tidewater Physical Therapy, LLC is a Physical Therapist in Stafford, 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.

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Practice location Address checks out

392 Garrisonville Rd Ste 208
Stafford, VA 22554-1576
Phone: (540) 602-4277
Fax: (540) 628-8581
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X (VA)

Record details

NPI number1790270973
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Tasheda Broughton — Manager, Credentialing · (252) 248-3313
Other names Pivot Physical Therapy Of Virginia
NPI enumeratedJune 29, 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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