Traci J Fairheart, DPT | |
201 Bulifants Blvd Ste B, Williamsburg, VA 23188-5731 | |
(757) 229-9740 | |
(757) 229-9741 |
Full Name | Traci J Fairheart |
---|---|
Gender | Female |
Speciality | Physical Therapist |
Location | 201 Bulifants Blvd Ste B, Williamsburg, Virginia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1710522529 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 2305202658 (Virginia) | Primary |
Provider Name | Tidewater Physical Therapy Llc |
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Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Provider Identifiers | NPI Number: 1457389595 PECOS PAC ID: 6406759281 Enrollment ID: O20041019001029 |
Mailing Address | Practice Location Address |
---|---|
Traci J Fairheart, DPT 5388 Discovery Park Blvd Ste 200, Williamsburg, VA 23188-8218 Ph: (757) 707-3955 | Traci J Fairheart, DPT 201 Bulifants Blvd Ste B, Williamsburg, VA 23188-5731 Ph: (757) 229-9740 |
Tidewater Physical Therapy, Llc Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 4125 Ironbound Rd, Ste 100, Williamsburg, VA 23188 Phone: 757-220-8383 Fax: 757-253-7833 | |
Tara Lee Perkins, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 111 Bulifants Blvd Ste A, Williamsburg, VA 23188 Phone: 757-564-7381 Fax: 757-564-7391 | |
Ann Degruy Scanlon, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 5700 Warhill Trl, Williamsburg, VA 23188 Phone: 757-912-2726 | |
D Russell Mosher, PT Physical Therapist Medicare: Medicare Enrolled Practice Location: 109 Bulifants Blvd, Suite B, Williamsburg, VA 23188 Phone: 757-229-9740 Fax: 757-345-6953 | |
Karen Mcpadden, MPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 5388 Discovery Park Blvd Ste 100, Williamsburg, VA 23188 Phone: 757-903-4230 Fax: 757-903-4231 | |
Reach For Performance, Inc Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 312 Lightfoot Rd, Suite J, Williamsburg, VA 23188 Phone: 757-258-1221 Fax: 757-258-7733 | |
Bryce Taylor Koob, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 6425 Richmond Rd, Williamsburg, VA 23188 Phone: 757-345-3242 |