Provider Demographics
NPI:1154844694
Name:CAROLINA PHYSICAL THERAPY ASSOCIATES LLC
Entity Type:Organization
Organization Name:CAROLINA PHYSICAL THERAPY ASSOCIATES LLC
Other - Org Name:CORA PHYSICAL THERAPY - CLAYTON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXEC. VP
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:KRZYMINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-221-6717
Mailing Address - Street 1:PO BOX 150
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45802-0150
Mailing Address - Country:US
Mailing Address - Phone:419-221-6717
Mailing Address - Fax:419-222-0507
Practice Address - Street 1:7277 NC HIGHWAY 42 STE 208
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27603-7528
Practice Address - Country:US
Practice Address - Phone:919-773-4086
Practice Address - Fax:919-773-4087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-17
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation