Organization
PERFORMANCE PHYSICAL THERAPY AND SPORTS TRAINING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER M HYDE MSPT (OWNER / CLINIC DIRECTOR)
(804) 874-2454
Entity
Organization
Contact information
Practice address
9130 DICKEY DR, SUITE A, MECHANICSVILLE, VA 23116-2502
(804) 874-2454
(804) 550-0971
Mailing address
9130 DICKEY DR, SUITE A, MECHANICSVILLE, VA 23116-2502
(804) 874-2454
(804) 550-0971
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
2305202826
VA
Other
Enumeration date
10/21/2009
Last updated
10/21/2009
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