Provider Demographics
NPI:1407614837
Name:SWEATALILBIT LLC
Entity Type:Organization
Organization Name:SWEATALILBIT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JORDAN
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:RODRIGUES
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:252-455-7317
Mailing Address - Street 1:6327 BRECKFIELD CT
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28278-6654
Mailing Address - Country:US
Mailing Address - Phone:252-455-7317
Mailing Address - Fax:
Practice Address - Street 1:6327 BRECKFIELD CT
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28278-6654
Practice Address - Country:US
Practice Address - Phone:252-455-7317
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy