Provider Demographics
NPI:1295480929
Name:PLAY TIME PHYSICAL THERAPY
Entity type:Organization
Organization Name:PLAY TIME PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OF PLAY TIME PHYSICAL THERAPY
Authorized Official - Prefix:DR
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:C
Authorized Official - Last Name:ROSE
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, C/NDT
Authorized Official - Phone:757-580-0766
Mailing Address - Street 1:129 COUNTRY CLUB BLVD
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23322-2137
Mailing Address - Country:US
Mailing Address - Phone:757-580-0766
Mailing Address - Fax:
Practice Address - Street 1:129 COUNTRY CLUB BLVD
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23322-2137
Practice Address - Country:US
Practice Address - Phone:757-580-0766
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-22
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty