Organization
CHURCHLAND PHYSICAL THERAPY SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARTIN BOYTEK JR. PHYSICAL THERAPIST (PRESIDENT/OWNER/PHYSICAL THERAPIST)
(757) 483-0333
Entity
Organization
Contact information
Practice address
5900 CHURCHLAND BLVD, PORTSMOUTH, VA 23703-3313
(757) 483-0333
(757) 483-9359
Mailing address
5900 CHURCHLAND BLVD, PORTSMOUTH, VA 23703-3313
(757) 483-0333
(757) 483-9359
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305000773
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
150870400
U.S.DEPT OF LABOR
VA
01
—
191880
ANTHEM BLUE CROSS
VA
01
—
200327
OPTIMA MEDICARE
VA
01
—
26207
OPTIMA PPO
VA
01
—
325835
MDIPA
VA
01
—
371787
MDIPA
VA
01
—
808578
MPN
VA
Enumeration date
07/01/2006
Last updated
11/29/2007
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