Provider Demographics
NPI:1093947004
Name:ASHEVILLE PHYSICAL THERAPY
Entity Type:Organization
Organization Name:ASHEVILLE PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:FOX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-277-7547
Mailing Address - Street 1:76 PEACHTREE RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-3395
Mailing Address - Country:US
Mailing Address - Phone:828-277-7547
Mailing Address - Fax:
Practice Address - Street 1:76 PEACHTREE RD
Practice Address - Street 2:SUITE 204
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-3395
Practice Address - Country:US
Practice Address - Phone:828-277-7547
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-10
Last Update Date:2010-09-23
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
NC2347846OtherMEDICARE PTAN
NC7200326Medicaid