Provider Demographics
NPI:1730294380
Name:MAY, PHILLIP SEBASTIAN (DPT)
Entity Type:Individual
Prefix:MR
First Name:PHILLIP
Middle Name:SEBASTIAN
Last Name:MAY
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:162 E BAYVIEW BLVD
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23503-4834
Mailing Address - Country:US
Mailing Address - Phone:757-587-9157
Mailing Address - Fax:
Practice Address - Street 1:2301 COLLEY AVE STE P
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23517-1144
Practice Address - Country:US
Practice Address - Phone:757-937-6307
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305203018225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist