Individual
DIANNA BISHOP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DSC, CERT MDT, C
Contact information
Practice address
2007 MEADE PKWY, SUFFOLK, VA 23434-4259
(757) 539-6300
(757) 539-0704
Mailing address
350 NEW FIDELITY CT, GARNER, NC 27529-2665
(919) 373-2919
(410) 648-4878
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305002030
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004979796
—
VA
01
—
1851555163
MEDICAID QMB
VA
01
—
C05954
MEDICARE GROUP NUMBER
VA
Enumeration date
07/16/2008
Last updated
08/10/2022
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