Provider Demographics
NPI:1386675965
Name:HANDS ON PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:HANDS ON PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:804-556-7181
Mailing Address - Street 1:PO BOX 57
Mailing Address - Street 2:
Mailing Address - City:GOOCHLAND
Mailing Address - State:VA
Mailing Address - Zip Code:23063-0057
Mailing Address - Country:US
Mailing Address - Phone:804-556-7181
Mailing Address - Fax:804-556-7182
Practice Address - Street 1:1940 SANDY HOOK RD
Practice Address - Street 2:SUITE F
Practice Address - City:GOOCHLAND
Practice Address - State:VA
Practice Address - Zip Code:23063-3107
Practice Address - Country:US
Practice Address - Phone:804-556-7181
Practice Address - Fax:804-556-7182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305004559225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA225795OtherSOUTHERN HEALTH
VA4700104OtherVIRGINIA PREMIER
VA236223OtherANTHEM
VA8945128Medicaid
VA43809OtherCARENET
VA8945128Medicaid