Provider Demographics
NPI:1508002411
Name:PHYTCARE LLC
Entity Type:Organization
Organization Name:PHYTCARE LLC
Other - Org Name:NEXTCARE INC SOLE MBR
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAUREL
Authorized Official - Middle Name:
Authorized Official - Last Name:STOIMENOFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-924-8382
Mailing Address - Street 1:PO BOX 41007
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28309-1007
Mailing Address - Country:US
Mailing Address - Phone:800-849-5609
Mailing Address - Fax:910-868-3216
Practice Address - Street 1:3680 ROBINWOOD RD
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-1676
Practice Address - Country:US
Practice Address - Phone:704-896-9701
Practice Address - Fax:704-853-2704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-23
Last Update Date:2008-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty