Provider Demographics
NPI:1659495224
Name:BKTODD INC
Entity Type:Organization
Organization Name:BKTODD INC
Other - Org Name:SIMPLY BALANCED PHYSICAL THERAPY & PILATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:BETSY
Authorized Official - Middle Name:BOWEN
Authorized Official - Last Name:TODD
Authorized Official - Suffix:
Authorized Official - Credentials:MS,PT
Authorized Official - Phone:757-498-4433
Mailing Address - Street 1:101 N LYNNHAVEN RD STE 205
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-7523
Mailing Address - Country:US
Mailing Address - Phone:757-498-4433
Mailing Address - Fax:757-498-4420
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305004752225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA189717OtherANTHEM INSURANCE