Provider Demographics
NPI:1497017537
Name:NORTH CAROLINA CENTER FOR PHYSICAL THERAPY
Entity Type:Organization
Organization Name:NORTH CAROLINA CENTER FOR PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELISA
Authorized Official - Middle Name:SWEET
Authorized Official - Last Name:PIDGEON
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:919-410-8840
Mailing Address - Street 1:5832 FAYETTEVILLE ROAD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-6290
Mailing Address - Country:US
Mailing Address - Phone:919-410-8841
Mailing Address - Fax:866-598-8851
Practice Address - Street 1:5832 FAYETTEVILLE ROAD
Practice Address - Street 2:SUITE 106
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-6290
Practice Address - Country:US
Practice Address - Phone:919-410-8841
Practice Address - Fax:866-598-8851
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-14
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP2461174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty