Provider Demographics
NPI:1164546156
Name:TODD, BETSY BOWEN (MS,PT)
Entity Type:Individual
Prefix:MRS
First Name:BETSY
Middle Name:BOWEN
Last Name:TODD
Suffix:
Gender:F
Credentials:MS,PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5304 HOLLY BLVD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23451-2352
Mailing Address - Country:US
Mailing Address - Phone:757-425-3855
Mailing Address - Fax:
Practice Address - Street 1:101 N LYNNHAVEN RD STE 205
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-7523
Practice Address - Country:US
Practice Address - Phone:757-498-4433
Practice Address - Fax:757-498-4420
Is Sole Proprietor?:No
Enumeration Date:2007-03-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305004752225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist