Provider Demographics
NPI:1487647251
Name:LENOIR PHYSICAL THERAPY AND SPORTS INJURY REHAB
Entity Type:Organization
Organization Name:LENOIR PHYSICAL THERAPY AND SPORTS INJURY REHAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:ARNETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-758-5238
Mailing Address - Street 1:PO BOX 2757
Mailing Address - Street 2:
Mailing Address - City:LENOIR
Mailing Address - State:NC
Mailing Address - Zip Code:28645-2757
Mailing Address - Country:US
Mailing Address - Phone:828-758-5238
Mailing Address - Fax:828-758-1074
Practice Address - Street 1:237 MCLEAN DR SW
Practice Address - Street 2:
Practice Address - City:LENOIR
Practice Address - State:NC
Practice Address - Zip Code:28645-6247
Practice Address - Country:US
Practice Address - Phone:828-758-5238
Practice Address - Fax:828-758-1074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7268261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2504115Medicare ID - Type Unspecified