Provider Demographics
NPI:1467810804
Name:ACCIDENT TREATMENT CENTER OF GREENSBORO
Entity Type:Organization
Organization Name:ACCIDENT TREATMENT CENTER OF GREENSBORO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DOMINIC
Authorized Official - Middle Name:ALI
Authorized Official - Last Name:HATCHER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:336-455-7231
Mailing Address - Street 1:2025 MARTIN LUTHER KING JR DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27406-3343
Mailing Address - Country:US
Mailing Address - Phone:336-455-7231
Mailing Address - Fax:336-455-7231
Practice Address - Street 1:2025 MARTIN LUTHER KING JR DR
Practice Address - Street 2:SUITE C
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27406-3343
Practice Address - Country:US
Practice Address - Phone:335-455-7231
Practice Address - Fax:336-455-7231
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-31
Last Update Date:2016-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation