Provider Demographics
NPI:1164937975
Name:1 ON 1 PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:1 ON 1 PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:T
Authorized Official - Last Name:FENTON
Authorized Official - Suffix:
Authorized Official - Credentials:DPT, MTC, CERTDN, CC
Authorized Official - Phone:828-785-8388
Mailing Address - Street 1:10 FORREST EDGE DRIVE
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28806-9539
Mailing Address - Country:US
Mailing Address - Phone:828-785-8388
Mailing Address - Fax:828-333-4898
Practice Address - Street 1:24 SARDIS RD
Practice Address - Street 2:SUITE B
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28806-9564
Practice Address - Country:US
Practice Address - Phone:828-785-8388
Practice Address - Fax:828-333-4898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-04
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy