Individual
PHYLLIS TACIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
928 DIAMOND SPRINGS RD STE 103, VIRGINIA BEACH, VA 23455-6601
(757) 395-1975
(757) 425-7180
Mailing address
928 DIAMOND SPRINGS RD STE 103, VIRGINIA BEACH, VA 23455-6601
(757) 395-1975
(757) 425-7180
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306601224
VA
Other
Enumeration date
12/17/2020
Last updated
12/17/2020
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