Provider Demographics
NPI:1356309090
Name:WILMINGTON PHYSICAL THERAPY INC
Entity Type:Organization
Organization Name:WILMINGTON PHYSICAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:PT MBA
Authorized Official - Phone:910-251-1818
Mailing Address - Street 1:2246 YAUPON DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-7329
Mailing Address - Country:US
Mailing Address - Phone:910-251-1818
Mailing Address - Fax:910-251-0462
Practice Address - Street 1:2246 YAUPON DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-7329
Practice Address - Country:US
Practice Address - Phone:910-251-1818
Practice Address - Fax:910-251-0462
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-03
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0784POtherBCBS
NC4495020001OtherDME MEDICARE
NC2503655OtherMEDICARE GROUP
NCDF4857OtherRR MEDICARE
NC7200002Medicaid
NC720784PMedicaid