Provider Demographics
NPI:1962574475
Name:PHYSICAL THERAPY ENTERPRISES, INC.
Entity type:Organization
Organization Name:PHYSICAL THERAPY ENTERPRISES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:F
Authorized Official - Last Name:SCHALL
Authorized Official - Suffix:
Authorized Official - Credentials:MS PT OCS
Authorized Official - Phone:757-459-2112
Mailing Address - Street 1:839 POPLAR HALL DR
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-3715
Mailing Address - Country:US
Mailing Address - Phone:757-459-2112
Mailing Address - Fax:757-459-2421
Practice Address - Street 1:839 POPLAR HALL DR
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-3715
Practice Address - Country:US
Practice Address - Phone:757-459-2112
Practice Address - Fax:757-459-2421
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2011-01-21
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
VAC06138Medicare ID - Type Unspecified