Provider Demographics
NPI:1245126374
Name:BLUESKY PHYSICAL THERAPY
Entity type:Organization
Organization Name:BLUESKY PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MARION
Authorized Official - Middle Name:A
Authorized Official - Last Name:LISENBY
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:757-404-0440
Mailing Address - Street 1:PO BOX 1615
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23451-9615
Mailing Address - Country:US
Mailing Address - Phone:757-404-0440
Mailing Address - Fax:
Practice Address - Street 1:139 SHIP SHOAL WAY
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23451-6544
Practice Address - Country:US
Practice Address - Phone:757-404-0440
Practice Address - Fax:757-524-4004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-16
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy