Provider Demographics
NPI:1346277316
Name:HEALING HANDS PHYSICAL THERAPY, INC.
Entity Type:Organization
Organization Name:HEALING HANDS PHYSICAL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:CAMPBELL
Authorized Official - Last Name:DOUGLAS
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:757-436-2695
Mailing Address - Street 1:676 BATTLEFIELD BLVD N STE C
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-0306
Mailing Address - Country:US
Mailing Address - Phone:757-436-2695
Mailing Address - Fax:757-436-2697
Practice Address - Street 1:676 BATTLEFIELD BLVD N STE C
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-0306
Practice Address - Country:US
Practice Address - Phone:757-436-2695
Practice Address - Fax:757-436-2697
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-27
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305005425225100000X
VA2305202603225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC09924Medicare ID - Type Unspecified