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 1972001147

Tidewater Physical Therapy LLC is a Physical Therapist in Midlothian, 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

2925 Polo Pkwy
Midlothian, VA 23113-1453
Phone: (804) 794-7587
Fax: (804) 794-4560
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 number1972001147
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Tasheda Broughton — Manager, Credentialing · (252) 248-3313
Other names Pivot Physical Therapy
NPI enumeratedJanuary 23, 2018
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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