Provider Demographics
NPI:1477197523
Name:COMPASS PHYSICAL THERAPY & CHIROPRACTIC, PLC
Entity Type:Organization
Organization Name:COMPASS PHYSICAL THERAPY & CHIROPRACTIC, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:D
Authorized Official - Middle Name:RUSSELL
Authorized Official - Last Name:MOSHER
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:757-539-2244
Mailing Address - Street 1:416 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-5236
Mailing Address - Country:US
Mailing Address - Phone:757-539-2244
Mailing Address - Fax:
Practice Address - Street 1:416 MARKET ST
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-5236
Practice Address - Country:US
Practice Address - Phone:757-539-2244
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-01
Last Update Date:2020-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty