Provider Demographics
NPI: | 1114599040 |
---|---|
Name: | BEST PHYSICAL THERAPY, LLC |
Entity Type: | Organization |
Organization Name: | BEST PHYSICAL THERAPY, LLC |
Other - Org Name: | RENEW PHYSIOTHERAPY |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | MARC |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | DOUEK |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 919-791-6260 |
Mailing Address - Street 1: | 1714 CANTERBURY RD |
Mailing Address - Street 2: | |
Mailing Address - City: | RALEIGH |
Mailing Address - State: | NC |
Mailing Address - Zip Code: | 27608-1110 |
Mailing Address - Country: | US |
Mailing Address - Phone: | |
Mailing Address - Fax: | |
Practice Address - Street 1: | 802 SEMART DR |
Practice Address - Street 2: | |
Practice Address - City: | RALEIGH |
Practice Address - State: | NC |
Practice Address - Zip Code: | 27604-8016 |
Practice Address - Country: | US |
Practice Address - Phone: | 919-791-6678 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | Yes |
Parent Organization LBN: | ACTIVE PHYSIO, LLC |
Parent Organization TIN: | <UNAVAIL> |
Enumeration Date: | 2021-07-12 |
Last Update Date: | 2024-04-08 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Group - Single Specialty |