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 1861906166

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

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

1149 Emancipation Hwy
Fredericksburg, VA 22401-4413
Phone: (540) 322-2518
Fax: (540) 739-7472
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 number1861906166
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Tasheda Broughton — Manager, Credentialing · (252) 248-3313
Other names Pivot Physical Therapy Of Virginia
NPI enumeratedNovember 22, 2017
Last updated in NPPESDecember 6, 2024
Certification dateDecember 6, 2024
Mailing address2122 York Rd Ste 300, Oak Brook, IL 60523-1925

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