Provider Demographics
NPI:1982475885
Name:P4 PHYSICAL THERAPY
Entity Type:Organization
Organization Name:P4 PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PT
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:D
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:276-732-1575
Mailing Address - Street 1:12349 MARTINSVILLE HWY
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24541-0855
Mailing Address - Country:US
Mailing Address - Phone:276-732-1575
Mailing Address - Fax:
Practice Address - Street 1:12349 MARTINSVILLE HWY
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24541-0855
Practice Address - Country:US
Practice Address - Phone:276-732-1575
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-10
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy