Provider Demographics
NPI:1811948003
Name:PHYSICAL THERAPY SPECIALISTS, P.C.
Entity type:Organization
Organization Name:PHYSICAL THERAPY SPECIALISTS, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:O
Authorized Official - Last Name:TEMPLETON
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:757-591-2668
Mailing Address - Street 1:704 THIMBLE SHOALS BOULEVARD
Mailing Address - Street 2:SUITE 400A
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4544
Mailing Address - Country:US
Mailing Address - Phone:757-591-2668
Mailing Address - Fax:757-591-2669
Practice Address - Street 1:704 THIMBLE SHOALS BOULEVARD
Practice Address - Street 2:SUITE 400A
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4544
Practice Address - Country:US
Practice Address - Phone:757-591-2668
Practice Address - Fax:757-591-2669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-13
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA195493OtherANTHEM
VA195493OtherANTHEM