Provider Demographics
NPI:1780196980
Name:PERSONAL BEST PHYSICAL THERAPY OF NORFOLK LLC
Entity Type:Organization
Organization Name:PERSONAL BEST PHYSICAL THERAPY OF NORFOLK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:
Authorized Official - Last Name:TITCOMB
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:508-530-4970
Mailing Address - Street 1:65 HOLBROOK ST STE 130
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:MA
Mailing Address - Zip Code:02056-1849
Mailing Address - Country:US
Mailing Address - Phone:774-565-0796
Mailing Address - Fax:774-565-8346
Practice Address - Street 1:65 HOLBROOK ST STE 130
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:MA
Practice Address - Zip Code:02056-1849
Practice Address - Country:US
Practice Address - Phone:774-565-0796
Practice Address - Fax:774-565-8346
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-27
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA22262225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty