Provider Demographics
NPI:1164930384
Name:ACUPT CLINIC INC.
Entity Type:Organization
Organization Name:ACUPT CLINIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:MORAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:828-606-0165
Mailing Address - Street 1:119 W FOX CHASE RD
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28804-1036
Mailing Address - Country:US
Mailing Address - Phone:828-606-0165
Mailing Address - Fax:
Practice Address - Street 1:133 WEAVERVILLE RD STE 2
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28804-1289
Practice Address - Country:US
Practice Address - Phone:828-606-0165
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-22
Last Update Date:2018-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP161072251S0007X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSportsGroup - Multi-Specialty