Provider Demographics
NPI:1093013351
Name:PROPTNC,LLC
Entity Type:Organization
Organization Name:PROPTNC,LLC
Other - Org Name:RESOLVE PHYSICAL THERAPY AND REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:SKULAVIK
Authorized Official - Suffix:
Authorized Official - Credentials:DPT, OCS
Authorized Official - Phone:516-220-5410
Mailing Address - Street 1:3409 OGLE DR
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-6410
Mailing Address - Country:US
Mailing Address - Phone:516-220-5410
Mailing Address - Fax:
Practice Address - Street 1:112 WALMART SUPERCENTER
Practice Address - Street 2:
Practice Address - City:SILER CITY
Practice Address - State:NC
Practice Address - Zip Code:27344-6756
Practice Address - Country:US
Practice Address - Phone:919-799-2226
Practice Address - Fax:919-799-2216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-09
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCH984OtherMEDICARE
NC1093013351Medicaid