Provider Demographics
NPI:1164860169
Name:MANUAL PHYSICAL THERAPY, INC
Entity Type:Organization
Organization Name:MANUAL PHYSICAL THERAPY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:SENGLAR-VITALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-544-0628
Mailing Address - Street 1:3200 NASH ST N
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27896-1231
Mailing Address - Country:US
Mailing Address - Phone:252-243-6784
Mailing Address - Fax:252-243-6782
Practice Address - Street 1:3200 NASH ST N
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27896-1231
Practice Address - Country:US
Practice Address - Phone:252-243-6784
Practice Address - Fax:252-243-6782
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-12
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1891757548OtherPERSONAL NPI #