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Organization
TIDEWATER PHYSICAL THERAPY LLC
Active
Organization
TIDEWATER PHYSICAL THERAPY LLC
Active
Other names
Pivot Physical Therapy of Virginia
Organization subpart
No
Provider details
NPI number
Authorized official
JUANA GRANADOS (DIRECTOR, CREDENTIALING)
(630) 575-1980
Entity
Organization
Contact information
Practice address
1580 ARMORY DR STE B, FRANKLIN, VA 23851-2470
(757) 562-0990
(757) 562-0496
Mailing address
2122 YORK RD STE 300, OAK BROOK, IL 60523-1925
(630) 575-6200
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
VA
261Q00000X
Clinic/Center
—
—
Other
Enumeration date
08/23/2011
Last updated
04/01/2026
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