Provider Demographics
NPI:1972274389
Name:HILL, CHARMAINE A (PTA)
Entity Type:Individual
Prefix:
First Name:CHARMAINE
Middle Name:A
Last Name:HILL
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:984B LASKIN RD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23451-3905
Mailing Address - Country:US
Mailing Address - Phone:757-395-6900
Mailing Address - Fax:757-425-7180
Practice Address - Street 1:984B LASKIN RD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23451-3905
Practice Address - Country:US
Practice Address - Phone:757-395-6900
Practice Address - Fax:757-425-7180
Is Sole Proprietor?:No
Enumeration Date:2021-09-24
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2366015225200000X
VA2306603135225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant