Provider Demographics
NPI:1043674609
Name:B3 THERAPY, PLLC
Entity Type:Organization
Organization Name:B3 THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:WILSON
Authorized Official - Last Name:HIATT
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L, CHT
Authorized Official - Phone:828-386-1285
Mailing Address - Street 1:325 WATER FALLS RD
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-5690
Mailing Address - Country:US
Mailing Address - Phone:704-450-0127
Mailing Address - Fax:
Practice Address - Street 1:324 HIGHWAY 105 EXT STE 12
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-6242
Practice Address - Country:US
Practice Address - Phone:828-386-1285
Practice Address - Fax:828-222-6030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-11
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0520261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC520OtherNC LICENSE