Provider Demographics
NPI:1437384492
Name:A JOINT VENTURE PHYSICAL THERAPY, L.L.C.
Entity Type:Organization
Organization Name:A JOINT VENTURE PHYSICAL THERAPY, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:VIVIAN
Authorized Official - Middle Name:KWEE
Authorized Official - Last Name:MAST
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:919-616-4487
Mailing Address - Street 1:9613 BERRYVILLE CT
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27617-7607
Mailing Address - Country:US
Mailing Address - Phone:919-616-4487
Mailing Address - Fax:919-233-6781
Practice Address - Street 1:3509 HAWORTH DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-7238
Practice Address - Country:US
Practice Address - Phone:919-616-4487
Practice Address - Fax:919-233-6781
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-20
Last Update Date:2009-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty