Provider Demographics
NPI:1629302559
Name:LITTLE HANDS LITTLE FEET PEDIATRIC THERAPY, PLLC
Entity Type:Organization
Organization Name:LITTLE HANDS LITTLE FEET PEDIATRIC THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRIC PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:K
Authorized Official - Last Name:BRIDGES
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:757-442-5437
Mailing Address - Street 1:PO BOX 252
Mailing Address - Street 2:
Mailing Address - City:EXMORE
Mailing Address - State:VA
Mailing Address - Zip Code:23350-0252
Mailing Address - Country:US
Mailing Address - Phone:757-442-5437
Mailing Address - Fax:
Practice Address - Street 1:3186 MAIN ST.
Practice Address - Street 2:
Practice Address - City:EXMORE
Practice Address - State:VA
Practice Address - Zip Code:23350-0252
Practice Address - Country:US
Practice Address - Phone:757-442-5437
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-24
Last Update Date:2010-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305005459261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy